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Review
. 2015:2015:796120.
doi: 10.1155/2015/796120. Epub 2015 Sep 29.

Comparison of Fine Needle Aspiration and Fine Needle Nonaspiration Cytology of Thyroid Nodules: A Meta-Analysis

Hongming Song  1 , Chuankui Wei  2 , Dengfeng Li  1 , Kaiyao Hua  1 , Jialu Song  1 , Niraj Maskey  1 , Lin Fang  1
Affiliations
Review

Comparison of Fine Needle Aspiration and Fine Needle Nonaspiration Cytology of Thyroid Nodules: A Meta-Analysis

Hongming Song et al. Biomed Res Int. 2015.

Abstract

Background: Fine needle aspiration cytology (FNAC) and fine needle nonaspiration cytology (FNNAC) are useful cost-effective techniques for preoperatively assessing thyroid lesions. Both techniques have advantages and disadvantages, and there is controversy over which method is superior. This meta-analysis was performed to evaluate the differences between FNAC and FNNAC for diagnosis of thyroid nodules.

Methods: Primary publications were independently collected by two reviewers from PubMed, Web of Science, Google Scholar, EBSCO, OALib, and the Cochrane Library databases. The following search terms were used: fine needle, aspiration, capillary, nonaspiration, sampling without aspiration, thyroid, and cytology. The last search was performed on February 1, 2015.

Results: Sixteen studies comprising 1,842 patients and 2,221 samples were included in this study. No statistically significant difference was observed between FNAC and FNNAC groups with respect to diagnostically inadequate smears, diagnostically superior smears, diagnostic performance (accuracy, sensitivity, specificity, negative predictive value, and positive predictive value), area under the summary receiver operating characteristic curve, average score of each parameter (background blood or clot, amount of cellular material, degree of cellular degeneration, degree of cellular trauma, and retention of appropriate architecture), and total score of five parameters.

Conclusion: FNAC and FNNAC are equally useful in assessing thyroid nodules.

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Figures

Figure 1
Figure 1
Flow chart of selection of eligible studies.
Figure 2
Figure 2
Forest plots showing the quality of specimens obtained by FNAC and FNNAC. (a) Unsuitable for diagnosis, (b) diagnostically superior.
Figure 3
Figure 3
Forest plot showing the diagnostic accuracy of FNNAC and FNAC techniques.
Figure 4
Figure 4
The summary receiver operating characteristic (SROC) curves for FNAC and FNNAC. The areas under the curve (AUCs) for FNAC and FNNAC were 0.9273 ± 0.0350 and 0.9047 ± 0.0458, respectively. There was no significant difference between the AUCs for FNAC and FNNAC (P > 0.05). Symmetric SROC curve fitted using Moses constant of linear model. SE: standard error. AUC: area under the curve.
Figure 5
Figure 5
Forest plots showing average scores of the five evaluation parameters for FNNAC and FNAC. (a) Background blood or clot, (b) degree of cellular trauma, (c) amount of cellular material, (d) degree of cellular degeneration, and (e) retention of appropriate architecture.
Figure 6
Figure 6
Forest plot showing the mean of the total scores of FNNAC and FNAC techniques.
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