Methodology Research Of Thyroid Nodules In Benign And Maligant Diagnosis

Background:Fine needle aspiration(FNA) has been widely used in the clinical diagnosis of thyroid nodules to determine whether further surgical treatment is required. It still has certain limitation in clinical application, such as puncture needle is too thin, the quantity of the cell sample is insufficient, and the pathological requirement is high. But tissue can be obtained more by using core needle biopsy(CNB) than FNA. It is useful on the clinical pathological diagnosis and typing. Comparison of the advantages and disadvantages of FNA and CNB in thyroid carcinoma diagnosis, only a few reports from China and other countries at present.Objective:The aim of this meta-analysis was to compare the sensitivity and specificity of FNA and CNB for the diagnosis of thyroid cancer.Methods:By searching literature, articles were selected with publication dates up to December31, 2013. Studies were identified by two independent reviewers using the search strategy.The sensitivity and specificity of FNA and CNB to identify the thyroid cancer are classified as the main results. Diagnostic accuracy is classified as a secondary outcome.The results of FNA and CNB in meta-analysis were collected and compared with the final diagnosis. Results were analyzed into statistic data.Results:1、Article selection and screening yielded five studies for meta-analysis, two of which were prospective and the other three retrospective, for a total of 1,264 patients.2、The total diagnostic sensitivity of FNA and CNB methods were 0.68 and 0.83,respectively, with specificity of 0.93 and 0.94. The areas under the summary ROC curves were 0.905(±0.030) for FNA and 0.745(±0.095) for CNB, with no significant difference between the two.3、No one study had greater influence than any other on the pooled estimates for diagnostic sensitivity and specificity.Conclusion:FNA and CNB do not differ significantly in sensitivity and specificity for diagnosis of thyroid cancer.