Comparative Evaluation of Thyroid Nodule Malignancy Risk: FNA, Touch-Imprint Cytology, and Permanent Pathology

One of the most prevalent forms of solid tumors, especially in women, is thyroid cancer, and it affects more people worldwide than ever before.

This study aimed to evaluate the accuracy of Fine Needle Aspiration (FNA) and touch-imprint cytology compared to permanent pathology, which is the gold standard in diagnosis.

This study was conducted as a retrospective cohort. According to the results of FNA and other supplementary tests, all the people who went to the Shahid Madani Medical Training Center in Karaj for a thyroid mass had indications for surgical removal of the thyroid mass and a definite diagnosis based on the final pathology.

A total of 110 people were included in the study, and the average age of all patients included in the study was 46.34 years, with 74.26% of patients being female and 25.74% being male. According to results from permanent pathology, there were 39 cases of thyroid cancer, compared to the 28, 29, and 30 cases of cancer reported by Fine-needle Aspiration Biopsy (FNAB), touch imprint, and frozen section cytology, respectively. In the FNAB test, sensitivity was 69.2%, specificity was 98.4%, positive predictive value was 96.4%, negative predictive value was 83.6%, and accuracy was 87.12%. In the touch-imprint cytology test, sensitivity was 74.4%, specificity was 98.4%, positive predictive value was 96.7%, negative predictive value was 85.9%, and accuracy was 89.1%. In the frozen section cytology, sensitivity was 76.9%, specificity was 100%, positive predictive value was 100%, negative predictive value was 87.3%, and accuracy was 91.09%.

The results of this study show that ultrasound, frozen section cytology, FNAB, and touch imprint have high accuracy in diagnosing thyroid malignancies compared to permanent pathology, so they can be used as a reliable method for diagnosing thyroid malignancies to prevent the use of invasive and very expensive methods like surgery.