Zamiri Mofid Mahsa, Ayubi Erfan, Tarokhian Aidin, Borzouei Shiva
Department of Medicine, Faculty of Medicine, Hamadan University Medical Sciences, Hamadan, Iran.
Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
J Res Health Sci. 2025 Jun 10;25(3):e00658. doi: 10.34172/jrhs.7768.
Thyroid nodules are common endocrine disorders. Most nodules are benign, with only 5% to 15% being malignant. Fine needle aspiration (FNA) is a primary diagnostic method; however, recent studies have raised concerns about its diagnostic reliability. This study aimed to evaluate performance of FNA in diagnosing thyroid nodules using pathology results as the gold standard. A cross-sectional study.
This study analyzed patients who were referred to an endocrine clinic in Hamadan city and underwent thyroidectomy during a 10-year period. The collected data included demographics, clinical symptoms, FNA results, and pathological outcomes. Statistical analysis was conducted using Stata software, with the significance level set at 0.05.
The study included 700 patients, predominantly female (86.2%), with a mean age of 42.5 years. FNA results were as follows: non-diagnostic in 4.8% (n=43), benign in 43.4% (n=304), atypia of undetermined significance or follicular lesion of undetermined significance in 6.1% (n=42), follicular neoplasm in 13.2% (n=92), suspicious for malignancy in 22.8% (n=160), and malignant nodules in 9.7% (n=68) of the cases. Pathology revealed malignant nodules in 56.9% (n=398) of the cases, predominantly papillary carcinoma. Significant factors associated with malignancy included younger age, male gender, history of thyroid cancer in a first-degree relative, and the presence of cervical adenopathy. FNA showed a sensitivity of 72.43% (95% CI 67.58%, 76.93%) and a specificity of 89.64% (95% CI 85.46%, 92.95%), with an accuracy of 79.85% (95% CI 76.55%, 82.87%).
While FNA is a valuable diagnostic tool for thyroid nodules, its sensitivity varies, necessitating close follow-up of patients with negative results.
甲状腺结节是常见的内分泌疾病。大多数结节是良性的，只有5%至15%为恶性。细针穿刺抽吸活检（FNA）是主要的诊断方法；然而，最近的研究对其诊断可靠性提出了担忧。本研究旨在以病理结果作为金标准，评估FNA在诊断甲状腺结节中的性能。一项横断面研究。
本研究分析了在10年期间转诊至哈马丹市一家内分泌诊所并接受甲状腺切除术的患者。收集的数据包括人口统计学信息、临床症状、FNA结果和病理结果。使用Stata软件进行统计分析，显著性水平设定为0.05。
该研究纳入了700例患者，以女性为主（86.2%），平均年龄为42.5岁。FNA结果如下：4.8%（n = 43）为无法诊断，43.4%（n = 304）为良性，6.1%（n = 42）为意义不明确的非典型性或意义不明确的滤泡性病变，13.2%（n = 92）为滤泡性肿瘤，22.8%（n = 160）怀疑为恶性，9.7%（n = 68）为恶性结节。病理显示56.9%（n = 398）的病例为恶性结节，主要为乳头状癌。与恶性相关的显著因素包括年龄较小、男性、一级亲属中有甲状腺癌病史以及存在颈部淋巴结病。FNA的敏感性为72.43%（95%可信区间67.58%，76.93%），特异性为89.64%（95%可信区间85.46%，92.95%），准确率为79.85%（95%可信区间76.55%，82.87%）。
虽然FNA是甲状腺结节诊断的一种有价值的工具，但其敏感性各不相同，因此对结果为阴性的患者需要密切随访。
