Ultrasoun,Fine Needle Aspiration Cytology And Radionuclide Scanning In Diagnosis Of Thyroid Nodule:A Systemetic Review

Objective:To compare ultrasound, FNAC, and radionuclide scan in diagnosis of thyroid nodules through meta-analysis.Methods:Chinese BioMedical Literature on disc(CBMdisc), China Academic Journal Network Publishing Database (CNKI), PubMed, EMBASE, the Cochrane Library databases and other databases were searched. The deadline is on February 1st,2015.We will select and assessment literatures according to the standard. Using Stata12.0 with Meta software to evaluate publication bias, using Meta - disc 1.4 software for evaluating threshold effect inspection and calculating sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnosis odds ratio and the area under the curve (AUC) to compare the diagnostic value of ultrasonic, needle aspiration cytology, radionuclide scan to thyroid nodule.Results:The number of patients using ultrasonography is 2785,the sensitivity (95% CI) is 0.74(0.71-0.78), the specificity (95% CI) is 0.90(0.89-0.92), the positive likelihood ratio(95%CI) is 6.84(3.69-12.66), the negative likelihood ratio(95% CI) is 0.30(0.24-0.38),the diagnosis odds ratio(95%CI) is 24.00(11.44-50.33), the AUC(SE) is 0.8993(0.0266); The number of patients using fine needle aspiration cytology is 6854,the sensitivity (95% CI) is 0.76(0.75-0.78), the specificity(95% CI) is 0.94(0.94-0.95), the positive likelihood ratio(95% CI) is 20.37(11.14-37.24), the negative likelihood ratio(95% CI) is 0.24(0.15-0.38),the diagnosis odds ratio(95% CI) is 84.81(51.40-139.95), the AUC(SE) is 0.9583(0.0113); The number of patients using emission computed tomography is 1462,the sensitivity (95% CI) is 0.79(0.74-0.84), the specificity(95% CI) is 0.41(0.38-0.44), the positive likelihood ratio(95% CI) is 1.21(1.02-1.43), the negative likelihood ratio(95% CI) is 0.59(0.35-1.01),the diagnosis odds ratio(95% CI) is 2.29(1.08-4.82), the AUC(SE) is 0.6342(0.0456).Conclusion:1.The diagnostic value of fine needle aspiration cytology of thyroid nodule is the highest, emission computed tomography is the worst;2. Fine needle aspiration cytology in the diagnosis of thyroid tumor with high accuracy, can clear the diagnosis of thyroid carcinoma, ultrasonography and emission computed tomography are significantly lower than the fine needle aspiration cytology.It can’t rely on ultrasonography and emission computed tomography to confirm the diagnosis of malignant tumor; 3.One single positive result of needle aspiration cytology, ultrasound, and radionuclide scanning can not exclude malignant tumor.