Abstract
We compared the efficacy and complications of core-needle biopsy (CNB) with those of fine-needle aspiration (FNA) in a large population of patients with initially detected thyroid nodules via a propensity score analysis. Outpatients with initially detected thyroid nodules, who had undergone CNB or FNA between January 2013 and December 2013, were selected. This study included 4,822 thyroid nodules from 4,553 consecutive patients. Adjustments for significant differences in patients’ baseline characteristics were facilitated via propensity score analysis. Subgroup analyses were performed according to nodule sizes ≥ 1 cm. The non-diagnostic result rate, malignancy rate, complication rate, and diagnostic accuracy were compared. A 1:1 matching of 1,615 patients yielded no significant differences between two groups for any covariate. The non-diagnostic result rate was significantly lower in the core-needle biopsy group than in the fine-needle aspiration group (5.2% vs. 12.1%), while the malignancy rate (23.7% vs. 11.8%) and sensitivity (75.9% vs. 55.6%) were significantly higher. However, the specificities were similar (100% and 99.9%, respectively). Propensity score and subgroup analyses showed similar results. The complication rate was similar between groups in matched cohorts. CNB is a promising and safe diagnostic tool for patients with initially detected thyroid nodules.
Highlights
Ultrasonography (US) guided, fine-needle aspiration (FNA) is considered to be a standard diagnostic tool for thyroid nodules, and is recommended by current practice guidelines[1]
We compared the outcomes of Core-needle biopsy (CNB) and FNA in a large population of patients with initially detected thyroid nodules by performing a propensity score analysis
Our observational study showed that CNB achieved a significantly lower non-diagnostic result rate and higher malignancy rate than that of FNA
Summary
Ultrasonography (US) guided, fine-needle aspiration (FNA) is considered to be a standard diagnostic tool for thyroid nodules, and is recommended by current practice guidelines[1]. Core-needle biopsy (CNB), as an alternative to FNA, has been introduced as a procedure for thyroid nodules with previously non-diagnostic or indeterminate results. Several recent studies demonstrated that CNB can effectively reduce the non-diagnostic result rate[11, 13,14,15,16] and minimize unnecessary and/or diagnostic surgery[10, 11, 14] for patients with thyroid nodules initially showing non-diagnostic or indeterminate results via FNA17. A recent small population pilot study (31 patients) reported that first-line use of CNB was more effective for suspicious thyroid nodules on US, compared to FNA18. We compared the efficacy and complications of CNB with those of FNA in a large population of patients with initially detected thyroid nodules via a propensity score analysis
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