Comparison Of Cytological Adequacy In Ultrasound-guided Fine-needle Aspiration Of Thyroid Nodules With Different Numbers Of Needle Passes

Objective A randomized and controlled prospective study was designed to compare the cytological adequate rates of different puncture needle numbers in FNAB of thyroid nodules and subgroup analysis was conducted according to different ultrasonic characteristics of nodules.The cytological adequacy of different number of needle passes in different subgroups was compared.This study will better guide clinical work.Methods This prospective randomized controlled study included 207 consecutive patients with 240 solid or predominately solid thyroid nodules undergoing ultrasound-guided fine needle aspiration at the Department of Endocrinology from September 2021 to March 2022.The nodules were randomly divided into a 1-needle group,a 2-needle group,and a 3-needle group(the random number was set to 20200811).All specimens were examined by cytopathological smear.The specimens were classified according to the Bethesda classification.Bethesda Ⅰ was recorded as satisfactory,and Bethesda Ⅱ-Ⅵ were recorded as unsatisfactory.Then,subgroup analysis was conducted according to ultrasonic characteristics of thyroid nodules.According to the size of nodules,it was divided into four subgroups:0.5cm～1.0cm,1.0cm～2.0cm,2.0cm～3.0cm and ≥3.0cm.According to different components of nodules,it was divided into two subgroups:solid and predominately solid.According to different echo of nodules,it was divided into three subgroups:hypothermic,Isoechoic and hyperechoic.It was divided into three subgroups:non-calcification,micro-calcification,and macro-calcification,according to the degree of calcification.The blood supply of thyroid nodules was then split into two subgroups:no blood supply and the blood supply.The cytological adequacy rates of different subgroups in 1-needle group,2-needle group and 3-needle group were compared.Results Totally 221 and 19 nodule specimens were considered as adequate and inadequate respectively,with an overall adequacy rate of 92.1%.There were no significant differences among the adequacy rates achieved with the 1,2,and 3-needle groups(91.3%,92.5%,and 92.5%respectively).Subgroup analysis was conducted according to different ultrasonic characteristics of nodules.In the 1-needle group,2-needle group and 3-needle group,there was no significant difference in the cytological adequacy rates of nodules in different subgroups.Conclusion For solid or predominately solid thyroid nodules,the number of needle passes does not significantly affect the cytological adequacy by ultrasound-guided fine-needle aspiration.The cytological adequacy of one needle pass is comparable to those of two and three needle passes.Moreover,the cytological adequacy of the number of needle passes had nothing to do with the fact the ultrasonic characteristics of nodules.