Thyroid nodules with initially non-diagnostic, fine-needle aspiration results: comparison of core-needle biopsy and repeated fine-needle aspiration

被引:67
作者
Choi, Sang Hyun [1 ]
Baek, Jung Hwan [1 ]
Lee, Jeong Hyun [1 ]
Choi, Young Jun [1 ]
Hong, Min Ji [1 ]
Song, Dong Eun [2 ]
Kim, Jae Kyun [3 ]
Yoon, Jong Ho [4 ]
Kim, Won Bae [5 ]
机构
[1] Univ Ulsan, Coll Med, Asan Med Ctr, Res Inst Radiol,Dept Radiol, Seoul 138736, South Korea
[2] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Pathol, Seoul 138736, South Korea
[3] Chung Ang Univ, Coll Med, Dept Radiol, Seoul 156755, South Korea
[4] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Surg, Seoul 138736, South Korea
[5] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Endocrinol & Metab, Seoul 138736, South Korea
关键词
Thyroid; Ultrasound; Fine-needle biopsy; Core-needle biopsy; Thyroid cancer; BETHESDA SYSTEM; MALIGNANCY; BENIGN; DIFFERENTIATION; CYTOPATHOLOGY; MANAGEMENT; DIAGNOSIS;
D O I
10.1007/s00330-014-3325-4
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
To evaluate the role of core-needle biopsy (CNB) by comparing the results of CNB and repeated fine-needle aspiration (FNA) for thyroid nodules with initially non-diagnostic FNA results. From October 2008 to December 2011, 360 nodules - 180 consecutive repeated FNAs and 180 consecutive CNBs -- from 360 patients (83 men, 277 women; mean age, 54.4 years) with initially non-diagnostic FNA results were analyzed retrospectively. The incidence of non-diagnostic results, inconclusive results, diagnostic surgery, and diagnostic performance of repeated FNA and CNB were assessed, and factors affecting second non-diagnostic results were evaluated. CNB achieved a significantly lower non-diagnostic and inconclusive rate than repeated FNA (1.1 % versus 40.0 %, P < 0.001; 7.2 % versus 72.0 %, P < 0.001). All diagnostic performances with CNB were higher than repeated FNA. The diagnostic surgery rate was lower with CNB than with repeated FNA (3.6 % versus 16.7 %, P = 0.047). Multivariate logistic regression analysis showed that repeated FNA was the most important factor for second non-diagnostic results (OR = 56.06, P < 0.001), followed by nodules with rim calcification (OR = 7.46, P = 0.003). CNB is more useful than repeated FNA for reducing the number of non-diagnostic and inconclusive results and for preventing unnecessary diagnostic surgery for thyroid nodules with initially non-diagnostic FNA results. aEuro cent Core-needle biopsy achieved a lower number of non-diagnostic and inconclusive results. aEuro cent Core-needle biopsy achieved better diagnostic performance. aEuro cent Use of core-needle biopsy could prevent unnecessary diagnostic surgery. aEuro cent Repeated fine-needle aspiration was significantly associated with a second non-diagnosis.
引用
收藏
页码:2819 / 2826
页数:8
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