Department of Otorhinolaryngology, Seoul National University College of Medicine, Bundang Hospital, Gyeonggi-Do, Seoul, Korea.
Head Neck. 2011 Feb;33(2):160-5. doi: 10.1002/hed.21414.
Thyroid fine-needle aspiration (FNA) is used as a screening test of choice for evaluation of thyroid nodules. However, approximately 15% to 25% of the cases are classified as indeterminate, posing dilemmas in decision-making. This study was designed to compare the diagnostic performances of second FNA and core needle biopsy of indeterminate nodules by initial FNA.
From February 2005 through June 2009, 258 patients who completed scheduled follow-ups were enrolled and the follow-up results were analyzed.
Nondiagnostic results were obtained in 41.8% of the second FNA group and in 1.7% of the core needle biopsy group (p < .001; chi-square). The nodules that show borderline features in preoperative ultrasonography had a malignancy rate of 18.3% and could be identified successfully with core needle biopsy.
Core needle biopsy is a better method for evaluating indeterminate nodules by initial FNA than second FNA, especially in patients with ultrasonographic findings of a borderline nodule.
甲状腺细针抽吸（FNA）是评估甲状腺结节的首选筛选试验。然而，大约 15%至 25%的病例被归类为不确定，这在决策时带来了困境。本研究旨在比较通过初始 FNA 进行第二次 FNA 和核心针活检对不确定结节的诊断性能。
从 2005 年 2 月至 2009 年 6 月，纳入了完成预定随访的 258 名患者，并对随访结果进行了分析。
第二次 FNA 组中有 41.8%的患者获得非诊断结果，而核心针活检组中仅有 1.7%（p<0.001；卡方）。术前超声检查显示边界特征的结节恶性率为 18.3%，并可通过核心针活检成功识别。
与第二次 FNA 相比，核心针活检是评估初始 FNA 不确定结节的更好方法，特别是对于超声检查有边界结节的患者。
