Pain Levels and Diagnostic Accuracy of Ultrasound-Guided Fine-Needle Aspiration Biopsy for Thyroid and Neck Masses: A Concordance Study with Definitive Pathology
Abstract
Background: FNA is the standard initial assessment for thyroid nodules. This study evaluated its diagnostic accuracy against postoperative histopathology.
Methods: In this study, histopathological results were compared with FNA findings in patients referred to a private clinic. Following approval by the institutional ethics committee, 180 patients presenting to the subspecialty outpatient clinics of the hospital due to thyroid nodules were enrolled in the study. Thyroid-stimulating hormone (TSH) testing was requested for all patients. Patients with a solitary thyroid nodule underwent FNA. In patients with multiple nodules, ultrasonography was performed initially, and FNA was subsequently carried out if suspicious nodules were identified on ultrasound examination. Subsequent to the FNA procedure, all collected specimens were submitted for pathological examination. Statistical processing and data analysis were subsequently executed through the IBM SPSS Statistics software
Results: Result showed, a total of 180 patients were included in the study. Based on FNA cytology results, 90.6% of patients were classified as benign, while 9.4% were classified as malignant. also, based on the final histopathological examination, 33.3% of patients were classified as benign, while 28.9% were categorized as suspicious for malignancy. The results demonstrated a high concordance between FNA and final histopathological findings. All 14 malignant cases were correctly identified by FNA, yielding a sensitivity of 100%. However, three cases diagnosed as malignant by FNA were found to be benign on final histopathological examination. Pain scores decreased significantly 5 minutes after the procedure compared with immediately after the procedure, as measured by both the VAS and NRS (P < 0.001).
Conclusion: While FNA is highly sensitive (100%) for detecting thyroid malignancies, the risk of false positives necessitates careful interpretation alongside histopathology to prevent unnecessary surgeries.
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| Fine-Needle Aspiration Thyroid Nodules Cancer Thyroid neoplasms Pain | ||
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