Evaluation of Fine-Needle Aspiration (FNA) Results and Comparison with Pathology Results After Thyroid Surgery
Abstract
Background: Given the clinical significance of thyroid carcinoma in the endocrine system, accurate diagnosis of malignant thyroid nodules remains a critical priority. Objectives: This study aimed to evaluate the diagnostic performance of fine-needle aspiration (FNA) compared with thyroid surgical histopathology as the reference standard. Methods: This retrospective cross-sectional study included patients aged 18 to 75 years with thyroid nodules who underwent thyroid surgery from March 2019 to March 2021. The initial diagnostic evaluation included a medical history, a physical examination, and ultrasonography. Demographic characteristics, thyroid hormone levels, and FNA cytology results were recorded using a researcher-developed checklist, and histopathological findings from thyroid surgery were subsequently collected. Results: A total of 102 patients were evaluated; 86.27% (n = 88) were women and 13.73% (n = 14) were men. The most common diagnoses based on FNA cytology and thyroid surgical histopathology were multinodular goiter (MNG) (n = 50, 49.02% vs. n = 26, 25.49%), papillary thyroid carcinoma (PTC) (n = 27, 26.47% vs. n = 25, 24.51%), and Hashimoto thyroiditis (n = 8, 7.84% vs. n = 13, 12.75%), respectively. The most common surgical procedures were total thyroidectomy (n = 68), lobectomy (right or left; n = 18), and lobectomy with isthmectomy (n = 16). The sensitivity for detecting lesion type was 51.52% (95% CI, 49.8%–53.2%), and the specificity was 76.81% (95% CI, 75.8%–77.8%). The false-positive rate was 23.19%, and the false-negative rate was 48.48%. The overall accuracy of FNA for correctly diagnosing the examined lesions was 68.6%. Conclusions: Although FNA remains a valuable clinical tool, the findings from this single-center retrospective cross-sectional study demonstrate moderate agreement with final histopathology and should therefore be interpreted with caution. The observed risk of malignancy among patients with benign cytological findings may not be fully generalizable to other populations or clinical settings.