Core Needle Biopsy Is a More Conclusive Follow-up Method Than Repeat Fine Needle Aspiration for Thyroid Nodules with Initially Inconclusive Results: A Systematic Review and Meta-Analysis
Journal of Pathology and Translational Medicine
;
: 217-224, 2016.
Article
in English
| WPRIM
| ID: wpr-11110
ABSTRACT
BACKGROUND:
This study investigated the appropriate management of thyroid nodules with prior non-diagnostic or atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) through a systematic review and meta-analysis.METHODS:
This study included 4,235 thyroid nodules from 26 eligible studies. We investigated the conclusive rate of follow-up core needle biopsy (CNB) or repeat fine needle aspiration (rFNA) after initial fine needle aspiration (FNA) with non-diagnostic or AUS/FLUS results. A diagnostic test accuracy (DTA) review was performed to determine the diagnostic role of the follow-up CNB and to calculate the area under the curve (AUC) on the summary receiver operating characteristic (SROC) curve.RESULTS:
The conclusive rates of follow-up CNB and rFNA after initial FNA were 0.879 (95% confidence interval [CI], 0.801 to 0.929) and 0.684 (95% CI, 0.627 to 0.736), respectively. In comparison of the odds ratios of CNB and rFNA, CNB had more frequent conclusive results than rFNA (odds ratio, 5.707; 95% CI, 2.530 to 12.875). Upon subgroup analysis, follow-up CNB showed a higher conclusive rate than rFNA in both initial non-diagnostic and AUS/FLUS subgroups. In DTA review of followup CNB, the pooled sensitivity and specificity were 0.94 (95% CI, 0.88 to 0.97) and 0.88 (95% CI, 0.84 to 0.91), respectively. The AUC for the SROC curve was 0.981, nearing 1.CONCLUSIONS:
Our results show that CNB has a higher conclusive rate than rFNA when the initial FNA produced inconclusive results. Further prospective studies with more detailed criteria are necessary before follow-up CNB can be applied in daily practice.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Thyroid Gland
/
Odds Ratio
/
Prospective Studies
/
ROC Curve
/
Follow-Up Studies
/
Sensitivity and Specificity
/
Thyroid Nodule
/
Area Under Curve
/
Biopsy, Fine-Needle
/
Diagnostic Tests, Routine
Type of study:
Diagnostic study
/
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
/
Systematic reviews
Language:
English
Journal:
Journal of Pathology and Translational Medicine
Year:
2016
Type:
Article
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