Abstract
Background:
Although fine-needle aspiration (FNA) is a safe and accurate diagnostic procedure for assessing thyroid nodules, it has limitations in diagnosing follicular neoplasms due to its relatively high false-positive rate. The purpose of the present study was to evaluate the diagnostic role of core-needle biopsy (CNB) for thyroid nodules with follicular neoplasm (FN) in comparison with FNA.
Methods:
A series of 107 patients (24 men, 83 women; mean age, 47.4 years) from 231 FNAs and 107 patients (29 men, 78 women; mean age, 46.3 years) from 186 CNBs with FN readings, all of whom underwent surgery, from October 2008 to December 2013 were retrospectively analyzed. The false-positive rate, unnecessary surgery rate, and malignancy rate for the FNA and CNB patients according to the final diagnosis following surgery were evaluated.
Results:
The CNB showed a significantly lower false-positive and unnecessary surgery rate than the FNA (4.7% versus 30.8%, 3.7% versus 26.2%, p<0.001, respectively). In the FNA group, 33 patients (30.8%) had non-neoplasms, including nodular hyperplasia (n=32) and chronic lymphocytic thyroiditis (n=1). In the CNB group, 5 patients (4.7%) had non-neoplasms, all of which were nodular hyperplasia. Moreover, the CNB group showed a significantly higher malignancy rate than FNA (57.9% versus 28%, p<0.001).
Conclusions:
CNB showed a significantly lower false-positive rate and a higher malignancy rate than FNA in diagnosing FN. Therefore, CNB could minimize unnecessary surgery and provide diagnostic confidence when managing patients with FN to perform surgery.
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