Diagnostic Accuracy and Risk of Malignancy of Liquid-Based Thyroid Fine-Needle Aspiration Cytology Compared with Histopathology: A Retrospective Study in Lampang Hospital, Thailand
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Abstract
Background: Fine-needle aspiration (FNA) is the standard method for preoperative evaluation of thyroid nodules. Liquid-based cytology (LBC) has increasingly been adopted; however, data on its diagnostic performance and risk of malignancy (ROM) in Thailand remain limited.
Objective: To evaluate the diagnostic performance of LBC in thyroid nodules and to determine the ROM across Bethesda categories.
Materials and methods: A retrospective study was conducted on patients who underwent thyroid LBC and subsequent surgery at Lampang Hospital between 2020 and 2024. Diagnostic indices, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, were calculated using histopathology as the reference standard. ROM was assessed for each Bethesda category.
Results: Of 1,328 cases, 361 underwent surgery, and 226 cases were included in performance analysis. Concordant cytology–histology results were observed in 186 cases, stratified by category. The false-positive and false-negative rates were 6.4% and 37.7%, respectively. Sensitivity was 62.3%, specificity 93.6%, PPV 81.1%, NPV 85%, and overall accuracy 84.1%. The ROM for nondiagnostic, benign, AUS, FN/SFN, suspicious for malignancy, and malignant categories was 11.4%, 8.7%, 32.3%, 14.3%, 96%, and 100%, respectively.
Conclusion: LBC demonstrates high specificity and good overall diagnostic accuracy in evaluating thyroid nodules, although sensitivity remains moderate. Integration with clinical and sonographic findings is essential for optimal management.
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บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
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