OBJECTIVE

To investigate the clinical application of fine needle aspiration (FNA) cytology of thyroid nodules.

METHODS

A retrospective review was performed of 474 consecutive cases of FNA cytology of thyroid nodules from October 2005 to January 2011. Two hundred and eighteen patients underwent ultrasound-guided FNA, and 256 patients experienced palpation-guided FNA. Cytologic diagnoses were classified as unsatisfactory, benign, atypical cellular lesion, follicular neoplasm, suspicious for malignancy, and positive for malignancy. The discrepancies between initial cytologic diagnoses and histologic diagnoses were evaluated in 157 surgical specimens.

RESULTS

According to the cytological categories, the rates for histologically confirmed malignancy in the 157 patients were as follows: 2/7 of unsatisfactory results, 16.7% (9/54) of benign lesion, 3/9 of atypical cellular lesion, 1/3 of follicular neoplasm, 83.3% (35/42) of suspicious for malignancies, and 97.6% (41/42) of positive for malignancies. The sensitivity, specificity and positive predictive value of thyroid FNA for the diagnosis of malignancy were 85.4%, 86.9% and 90.5%, respectively.

CONCLUSIONS

FNA can provide an accurate diagnosis of thyroid malignancy preoperatively. The 6 diagnostic categories were beneficial for either clinical follow-up or surgical management of the patients with thyroid nodules.