Evaluation Of The Efficacy And The Limitation Of Ultrasound-guided Core-needle Biopsy, Core-needle Aspiration And Fine-needle Aspiration In Micro-nodules Of Thyroid

[Objective]To prospectively evaluate the efficacy and the limitation of ultrasound-guided core-needle biopsy, ultrasound-guided core-needle aspiration and ultrasound-guided fine-needle aspiration in micro-nodules of thyroid.[Methods]Two hundred consecutive patients detected and suspicious for malignant micro-nodules of thyroid by ultrasound during January 4th,2012 and April 4th,2014. Two groups were classified according different operation,100 patients underwent US-FNA and US-CNA, and the other 100 ones underwent US-FNA and US-CNB.92 patients (40 cases in group one,52 cases in group two) were enrolled, and these patients were underwent surgical operation and diagnosed by pathology. Compared with the histopathological examination after surgery, efficacy and limitation were evaluated between them.[Results]Of 40 cases with US-FNA and US-CNA, unsatisfactory specimen of US-CNA occurred in 14 cases and satisfactory specimen of US-CNA were got in 26 cases; unsatisfactory specimen of US-FNA occurred in 4 cases and satisfactory specimen of US-FNA.Among 52 cases with both US-FNA and US-CNB,41 got nondiagnostic US-CNB and 11 cases successfully got the correct diagnoses of US-CNB, the accuracy was 100%; 6 cases got the incorrect diagnosis of US-FNA and 46 cases got the correct diagnosis of US-FNA, the accuracy was 88.5%.76 of 92 micro-nodules of thyroid were diagnosed of malignancy. According to the cytological categories, the rates for histologically confirmed malignancy in the 92 micro-nodules were as follows:0%(0/1) of unsatisfactory results,16.7%(1/6) of benign lesion,20.0%(2/10) of atypical cellular lesions,100.0%(2/2) of follicular neoplasm, 93.9%(31/33) of suspicious for malignancy, and 100.0%(40/40) of positive for malignancy, respectively.The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US-FNA in 92 cases for the diagnosis of malignancy were 93.4%,86.7%, 97.3%,72.2% and 92.3%, respectively.[Conclusions]1 US-FNA sampling technique is superior to US-CNA sampling technique.2 US-CNB is not suitable for the diagnosis of micro-nodules in thyroid.3 US-FNA is proved to be more valuable than other puncture methods for the diagnosis of suspectable malignant micro-nodules in thyroid before operation.