Value of Fine Needle Aspiration Cytology and Core Needle Biopsy in the Head and Neck Region

Background: Fine-needle aspiration cytology (FNAC) and core-needle biopsy (CNB) represent 2 minimal invasive methods for further assessment of suspect lesions of the head and neck area. However, only limited data on the direct comparison of both methods has been published. The aim of this retrospective study was to evaluate the diagnostic value of FNAC and CNB and to compare their sensitivity and specificity. Material and methods: Between 2005 and 2012, CNB was performed in 86 patients and FNAC in 408 patients. 52 of 86 CNB-patients and 224 of 408 FNAC-patients underwent surgery afterwards and were included into the study (n = 276). In order to compare the results of both methods the corresponding final histopathological finding from surgery was considered. Results: The sensitivity of the FNAC-group was higher (85 %) compared to the CNB-group (80 %), the specificity (87 vs. 94 %) as well as the positive predictive value (64 vs. 97 %) was lower. The negative predictive value (92 vs. 71 %) and also the false negative value of the FNAC (5 vs. 13 %) were superior to the results of the CNB-group. Concerning the false positive value the CNB-group showed better results (2 vs. 15 %). Conclusion: Both methods are well suited to clarify the dignity of lesions in the head and neck region. In the current case series, FNAC seemed particularly suitable for diagnosis of hematologic diseases and the exclusion of malignancy in suspicious lymph nodes. The GNP has proven to be valid in the detection of tumor recurrences in irradiated or previously operated tissue, furthermore the definitive oncological treatment can be planed, based on the histopathological results obtained by GNP.