Archana Elangovan, Vijayakumar Chellappa, Raj Kumar Nagarajan, Balasubramanian Gopal, Srinivasan Krishnamachari, Sreenath G S, Siddaraju N
Department of Surgery, Jawaharlal Institute of Postgraduation Medical Education and Research, Puducherry, India.
Department of Pathology, Jawaharlal Institute of Postgraduation Medical Education and Research, Puducherry, India.
Niger J Surg. 2020 Jul-Dec;26(2):147-152. doi: 10.4103/njs.NJS_29_20. Epub 2020 Jul 27.
Aspiration cytology is one of the first-line diagnostic tests in thyroid malignancies. Fine-needle aspiration cytology (FNAC) in thyroid lesions causes hemorrhagic smear and cell trauma, often leading to the repetition of smear and delay in diagnosis. This study was conducted to identify the diagnostically superior technique with regard to thyroid swelling and to assess the quality of smears obtained from FNAC and fine-needle nonaspiration cytology (FNNAC).
This was a prospective diagnostic study carried out for 2 years in a tertiary care center from South India. All patients with complaints of thyroid swellings, after examination, underwent FNNAC, followed by FNAC of the lesion. They underwent thyroidectomy when indicated. The final postoperative biopsy reports were compared with the preoperative reports of these two techniques (FNNAC and FNAC). The quality of smears was compared using Mair's score.
The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in diagnosing malignancy were 93.4%, 100%, 100%, 98.78%, and 98.96% for FNNAC and 94.12%, 100%, 100%, 98.82%, and 99% for FNAC, respectively, which were comparable. Regarding the quality of smears, FNNAC had more smears with less blood in the background. FNAC had more smears with adequate cellularity. The difference in overall Mair's score between the two techniques was not significant ( = 0.28).
No difference was found in the accuracy of FNAC and FNNAC in diagnosing thyroid lesions. Furthermore, the smear quality of both techniques was comparable. Hence, either can be used based on the operator's preference and experience.
细针穿刺抽吸活检术是甲状腺恶性肿瘤的一线诊断检查方法之一。甲状腺病变的细针穿刺抽吸活检术（FNAC）会导致出血涂片和细胞损伤，常导致涂片重复和诊断延迟。本研究旨在确定甲状腺肿大诊断方面更具优势的技术，并评估从FNAC和细针非抽吸活检术（FNNAC）获得的涂片质量。
这是一项在印度南部一家三级医疗中心进行的为期2年的前瞻性诊断研究。所有主诉甲状腺肿大的患者，经检查后先进行FNNAC，然后对病变进行FNAC。有指征时进行甲状腺切除术。将最终的术后活检报告与这两种技术（FNNAC和FNAC）的术前报告进行比较。使用迈尔评分比较涂片质量。
FNNAC诊断恶性肿瘤的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为93.4%、100%、100%、98.78%和98.96%，FNAC分别为94.12%、100%、100%、98.82%和99%，两者具有可比性。关于涂片质量，FNNAC背景中血液较少的涂片更多。FNAC细胞数量充足的涂片更多。两种技术的总体迈尔评分差异不显著（P = 0.28）。
在诊断甲状腺病变方面，FNAC和FNNAC的准确性没有差异。此外，两种技术的涂片质量具有可比性。因此，可根据操作者的偏好和经验选择使用其中任何一种。
