Abstract
Introduction : Fine needle aspiration cytology (FNAC) is regarded as an important first line investigation for evaluation of thyroid swellings. It has a diagnostic accuracy of over 90% in terms of specificity, sensitivity and predictive values. Objective : The aim of this study was to determine the validity (specificity, sensitivity positive/negative predictive values) of FNAC in the diagnosis of thyroid diseases. Methods : FNAC reports and histopathology reports of patients with thyroid diseases, who have undergone surgery, were retrospectively retrieved from data banks in the Department of Pathology, University of Sri Jayewardenepura, from August 2004 to August 2006. In addition a prospective study in patients with thyroid diseases who came to this unit for FNAC from June to September 2006 was carried out. In all the cases the histological diagnosis was compared with the cytological diagnosis and the results were documented and analyzed by using standard statistical methods. Results : FNAC has an acceptable validity in the diagnosis of thyroid diseases with high specificity (86.74%), sensitivity (84.05%), positive predictive value (84.05%) and negative predictive value (86.74%). Keywords: thyroid cytology; specificity; sensitivity; positive and negative predictive values. DOI: 10.4038/jdp.v5i1.2956 Journal of Diagnostic Pathology 2006/07; 5: 19-29
Highlights
Fine needle aspiration cytology (FNAC) is regarded as an important first line investigation for evaluation of thyroid swellings
Several studies based on different methodologies have reported a high degree of sensitivity, specificity, positive and negative predictive values of FNAC for thyroid.[5]
Cytological diagnosis of follicular adenoma versus carcinoma is not possible with fine needle aspiration and diagnosis is dependent on histological assessment for capsular or vascular invasion
Summary
Fine needle aspiration cytology (FNAC) is regarded as an important first line investigation for evaluation of thyroid swellings. The incidence of thyroid cancers is approximately 122,000 new cases per year worldwide.[1] In Sri Lanka, thyroid cancers are responsible for 4.6% of all cancers and account for 6.9% of cancers in females.[2] Fine Needle Aspiration Cytology (FNAC) is widely accepted a simple and minimally invasive investigation in the assessment of nodular thyroid disease and has shown to have a high sensitivity in diagnosing malignancies as well as in the evaluation of thyroid nodules.[3] At present, in Sri Lanka, FNAC is used as a routine first line diagnostic method to assess thyroid diseases As it is a simple technique which can be carried out in the out-patient department, it can be readily repeated if necessary, and has good patient compliance. FNAC entails some difficulties in small thyroid enlargements, and sampling errors in inexperienced hands it can be a rapid and useful diagnostic investigation
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