Predictive Index for Carcinoma of Thyroid Nodules and Its Integration with Fine-Needle Aspiration Cytology

Abstract

Background. The objective of this study was to select patients for resection of thyroid malignity among patients with thyroid nodules by integration of predictive indices with fine-needle aspiration cytology (FNAC). Methods. Characteristics of 571 euthyroid patients with thyroid nodules who underwent surgery in our institution were prospectively recorded. Predictive factors for malignancy were identified and categorized as predictive indices that were integrated with FNAC to select patients for surgery. Results. Eighty-three (14.5%) of the 571 patients had thyroid carcinoma. Size ≥4 cm, age ≥65, cervical lymph nodes, solid structure, hypoechogenicity, microcalcification, and elevated serum thyroglobulin levels were independent predictive factors associated with thyroid malignancy. Sensitivity, specificity, and accuracy of FNAC were 88%, 80%, and 81%, respectively, and were 100% for index 3. Conclusions. Patients with malignant and suspicious FNAC findings and, among patients with follicular neoplasm and nondiagnostic FNAC findings, those with ≥2 risk factors should undergo surgery. © 2009 Wiley Periodicals, Inc.