Comparison of the adequacy of specimens provided by fine needle aspiration, fine needle non – aspiration sampling and combined technique in thyroid nodules

AbstractBackground and Purpose: Thyroid dysfunctions are one of the most important diseases in endocrinology. Fine needle aspiration (FNA) is currently the first line diagnostic tool for the evaluation of thyroid nodules. The adequacy of specimens provided by this method is also very important. FNA puncture in thyroid causes intra- parenchyma hemorrhage, which may distribute the quality of tissue specimens. Fine needle non-aspiration (FNNA), may provide better specimens without this problem. The aim of this study was to evaluate the adequacy of thyroid nodules specimens provided by fine needle aspiration and fine needle non – aspiration sampling in Imam Hospital.Materials and Methods: This descriptive study was performed on 200 patients with thyroid nodules in Imam Hospital, Sari, Iran. After a detailed clinical history, systemic examination and thyroid sonography, FNA and FNNA sampling were performed in all patients. The adequacy of specimens was evaluated by Mair scoring system in both techniques. All data, including demographic data and sonographic results and background blood, amount of cellular material, degree of cellular degeneration, degree of cellular trauma and retention of appropriate architecture were recorded. Results were analyzed by means of SPSS (11) software and Wilcoxon Signed Rank Test. The P.value less than 0.05 were considered to be significant statistically.Results: 200 patients, 189 (94.5%) females and 11 (5.5%) males, with mean age of 43.36±12.3 years were studied. Cytological findings showed that in FNA technique, 26(13%) of specimens were unsuitable for diagnosis, 97(48.5%) were diagnostic/adequate, while 77(38.5%) were diagnostic/superior for diagnosis. In FNNA technique, 32(16%) of specimens were unsuitable, 96 (48%) were diagnostic/ adequate, while 72 (36%) were diagnostic/superior for diagnosis. In the combined application of FNA and FNNA, 9 (4.5%) of specimens were not diagnostible and 191 (95.5%) were diagnostic. Mean of total score in FNA was 5.82±2.3, while in FNNA was 5.70±2.4, with the difference was not statistically significant. Furthermore, there was no statistically significant difference between other parameters.Conclusion: Our study demonstrates that there is no difference between FNA and FNNA sampling, however, applying the combination of these two techniques, may improve the diagnostic quality.Key words: Thyroid, Nodules, Fine needle aspiration, Fine needle non-aspirationJ Mazand Univ Med Sci 2008; 18(63): 1-10 (