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KMID : 0365719960120010008
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Journal of Pusan Surgical Society
1996 Volume.12 No. 1 p.8 ~ p.15
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The Role of Preoperative Fine Needle Aspiration Cytology (FNAC) in Differential Diagnosis of Thyroid Nodule
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Abstract
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Fine Needle Aspiration Cytology (FNAC) is widely accepted as the most accurate procedure to differentiate benign from malignant thyroid nodules. It is a simple, safe and inexpensive procedure. The accuracy of FNAC is variable and is generally
dependent
upon different factors, the most important being the experience and the skill of the cytologist.
Therefore, to evaluate the diagnostic value of preoperative FANC in differential diagnosis of thyroid nodule. Author studied 350 cases of thyroid nodule which had been surgically resected.
@ES The following results were obtained :
@EN 1) The number of inadequate smear (sampling error) was 55 cases (15.7%).
2) Preoperative cytologic diagnosis revealed benign diseases in 198 cases (nodular goiter in 92 cases, follicular lesion type III in 96 cases, thyroiditis in 10 cases), highly suspicious malignant lesion(follicular lesion type II) in 12 cases
and
malignant disease in 85 cases (papillary carcinoma in 71 cases, follicular lesion type I in 14 cases). Histology confirmed benign disease in 181 cases (nodular goiter in 116 cases, adenoma in 66 cases, thyroiditis in 9 cases) and malignant
disease
in
104 cases (papillary carcinoma in 84 cases, follicular carcinoma in 20 cases( (p=0.00).
3) The sensitivity of FNAC was 84.6%, specificity was 95.2%, false negative rate was 15.3%, false positive rate was 4.7%%, positive predictive value was 90.7%, negative predictive value was 91.9%, and overall accuracy was 91.5%, respectively.
4) In 55 cases of inadequate smear, 13 cases (23.6%) were confirmed malignant neoplasm histologically.
5) 16 cases of false negative were confirmed papillary carcinoma in 9 cases, follicular carcinoma in 7 cases.
6) Cystic thyroid nodule was 27% (81/350) and 13 cases (16.1%) confirmed malignant neoplasm.
In conclusion, FNAC is useful diagnostic method and procedure of choice in the initial screening of thyroid nodules. Inadequate smear and false negative rate will be reduced with careful repeated examination.
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KEYWORD
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