Core-Needle Biopsy Does Not Show Superior Diagnostic Performance to Fine-Needle Aspiration for Diagnosing Thyroid Nodules
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Purpose: To compare the diagnostic performances of fine-needle aspiration (FNA) and core-needle biopsy (CNB) for thyroid nodulesaccording to nodule size. Materials and Methods: This retrospective study included 320 thyroid nodules from 320 patients who underwent both FNA andCNB at outside clinics and proceeded with surgery in our institution between July 2012 and May 2019. According to nodule size,the diagnostic performances of FNA and CNB were calculated using various combinations of test-negatives and test-positives definedby the Bethesda categories and were compared using the generalized estimated equation and the Delong method. Results: There were 279 malignant nodules in 279 patients and 41 benign nodules in 41 patients. The diagnostic performance ofFNA was mostly not different from CNB regardless of nodule size, except for negative predictive value, which was better for FNAthan CNB when applying Criteria 1 and 2. When applying Criteria 3, the specificity and positive predictive value of FNA were superiorto CNB regardless of size. When applying Criteria 4, diagnostic performance did not differ between FNA and CNB regardlessof size. After applying Criteria 5, diagnostic performance did not differ between FNA and CNB in nodules ≥2 cm. However, innodules ≥1 cm and all nodules, the sensitivity, accuracy, and negative predictive value of CNB were better than those of FNA. Conclusion: CNB did not show superior diagnostic performance to FNA for diagnosing thyroid nodules.
Abstract
Purpose: To compare the diagnostic performances of fine-needle aspiration (FNA) and core-needle biopsy (CNB) for thyroid nodulesaccording to nodule size. Materials and Methods: This retrospective study included 320 thyroid nodules from 320 patients who underwent both FNA andCNB at outside clinics and proceeded with surgery in our institution between July 2012 and May 2019. According to nodule size,the diagnostic performances of FNA and CNB were calculated using various combinations of test-negatives and test-positives definedby the Bethesda categories and were compared using the generalized estimated equation and the Delong method. Results: There were 279 malignant nodules in 279 patients and 41 benign nodules in 41 patients. The diagnostic performance ofFNA was mostly not different from CNB regardless of nodule size, except for negative predictive value, which was better for FNAthan CNB when applying Criteria 1 and 2. When applying Criteria 3, the specificity and positive predictive value of FNA were superiorto CNB regardless of size. When applying Criteria 4, diagnostic performance did not differ between FNA and CNB regardlessof size. After applying Criteria 5, diagnostic performance did not differ between FNA and CNB in nodules ≥2 cm. However, innodules ≥1 cm and all nodules, the sensitivity, accuracy, and negative predictive value of CNB were better than those of FNA. Conclusion: CNB did not show superior diagnostic performance to FNA for diagnosing thyroid nodules.
참고문헌 (30)
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