Usage and Diagnostic Yield of Fine-Needle Aspiration Cytology and Core Needle Biopsy in Thyroid Nodules: A Systematic Review and Meta-Analysis of Literature Published by Korean Authors

Abstract

Objectives. The usefulness of core needle biopsy (CNB) for the diagnosis of thyroid nodules remains controversial, and preferences vary across hospitals. The purpose of this study was to assess the actual use of CNB in Korea and to analyze the advantages and disadvantages of CNB through a systematic review and meta-analysis of papers published by Korean authors. Methods. A meta-analysis of full-text publications published in English presenting data from Korea retrieved from the Embase literature database was performed. Results. CNB led to a significantly lower proportion of non-diagnostic results than fine-needle aspiration (FNA). However, the frequency of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) did not decrease as a result of performing CNB in nodules with initial AUS/FLUS results, while it increased in consecutive cases. A subcategory analysis of AUS/FLUS showed that the increased frequency of AUS/FLUS findings on CNB was due to more frequent diagnoses of architectural atypia and follicular neoplasm, which resulted in a higher frequency of inconclusive findings in consecutive cases compared to FNA. Hospitals favoring CNB had a higher proportion of AUS/FLUS diagnoses. Although the complication rate did not differ significantly between CNB and FNA, serious complications of CNB did occur. Conclusion. A reduced frequency of non-diagnostic results may be a definite advantage of CNB over FNA. However, the increased frequency of diagnoses of architectural atypia and follicular neoplasm should be considered when selecting CNB as a diagnostic tool.

Intraoperative Assessment of High-Risk Thyroid Nodules Based on Electrical Impedance Measurements: A Feasibility Study

“…In recent years, core needle biopsy (CNB) from thyroid nodules has been recommended for previous inconclusive FNAs [ 21 ]. Also, some researchers have confirmed that CNB could overcome the limitations of FNA in these lesions [ 10 , 13 , 22 , 23 ]. However, the role of CNB has not been well established for the assessment of thyroid nodules with suspicious US features [ 10 ].…”

The Diagnostic Role of Repeated Biopsy of Thyroid Nodules with Atypia of Undetermined Significance with Architectural Atypia on Core-Needle Biopsy

“…Therefore, CNB has been increasingly utilized as a first-line diagnostic tool for initially detected thyroid nodules [11]. However, recent meta-analysis reported that CNB had higher proportion of indeterminate follicular lesions than FNA, with 72% of nodules diagnosed as indeterminate follicular lesions on CNB being due to architectural atypia [12].…”

A circulating microRNA panel as a novel dynamic monitor for oral squamous cell carcinoma

“…In the diagnosis and prevention of OSCC, emphasis is placed on identifying potential malignant lesions of the oral mucosa and local diseases that promote chronic inflammation, mainly relying on objective clinical examinations and surgical biopsy 5 , 6 . Although surgical biopsy is the gold standard for the diagnosis of OSCC, it is somewhat invasive and can sometimes be harmful to patients 7 .…”