Abstract
Purpose Widespread use of sensitive ultrasound examination led to an increasing detection of medullary thyroid microcarcinoma (micro-MTC). This prospective study evaluated the diagnostic accuracy of Fine-needle Aspiration Biopsy Cytology (FNAB-C) and calcitonin assay in Fine-needle Aspiration Biopsy wash-out fluid (FNAB-CT) in thyroid nodules less than 1cm with elevated serum calcitonin. Methods 87 thyroid nodules from 60 patients with elevated serum calcitonin(＞10pg/ml) were included and 51 were thyroid nodules less than 1cm. FNAB-CT and FNAB-C was performed to distinguish MTC lesions before surgery, histopathologic diagnoses served as main reference standards.Results FNAB-CT had a greater performance over FNAB-C for preoperative diagnosis of MTC (diagnostic accuracy: 98.85％vs 61.90％, sensitivity: 98.55％ vs 55.07％, specificity: 100％ vs 97.44％), especially for micro-MTC: FNAB-C established a sensitivity and diagnostic accuracy of 48.78％ and 58％ respectively, while FNAB-CT reached 97.56% sensitivity and 98.04% diagnostic accuracy. Conclusions FNAB-CT demonstrated high diagnostic accuracy in diagnosing micro-MTC. Patients with micro thyroid nodules and elevated sCT level should perform FNAB-CT to exclude the diagnosis of MTC lesions.
Diagnostic Accuracy of Fine Needle Aspiration for Solitary and Multiple Thyroid Nodules in a Tertiary Care Center