The combination of ATA classification and FNA results can improve the dia

Abstract

Purpose: To determine the diagnostic efficiency of the ATA classification a nd ultrasound-guided fine-needle aspiration (FNA) results in identifying the r isk factors of malignancy, we analyzed the thyroid nodules of patients who underwent thyroidectomy and compared preoperative ATA classifications with FNA results. Methods: We retrospectively analyzed 274 nodules of 196 patients who und erwent ultrasonography, FNA and thyroidectomy. Histopathological findings of thyroid nodules were considered as the Au standard in the analysis of the diagn ostic efficiency of the ATA classification and FNA results. Univariate analysis and bina ry multivariate logistic regression analysis were applied to identify the ultrasound features associated with malignancy. Results: The overall malignancy rate of 274 nodules was 41.6%. The areas under the ROC curves (AUCs) for the ATA classification and FNA results were 0. 88 and 0.878, respectively (P < 0.001). The sensitivity and specificity of the ATA classificat ion were 86 and 86.9%, whereas those of FNA results were 68.5 and 91.4%, respectively. The specificity (98.7%) and sensitivity (94.3%) increased after the combined use of the ATA classification and FNA results. Taller-than-wide shape, microcalcifications, hypoechogenicity and irregular margins were independent risk factors for malignancy. Microcalc ifications had the highest OR (7.58), and taller-than-wide shape had the highest s pecificity in BSRTC I, II, III and IV cytology. Conclusion: The diagnostic efficiency of the ATA classification and FNA result s in identifying malignant nodules was high, and the use of both criteria improv ed the diagnostic accuracy. Taller-than-wide shape, microcalcifications, hypoechogenicity and irregular margins were independent risk factors for malignancy.

Keywords

• thyroid nodule
• ultrasound features
• fine-needle aspiration
• ata guidelines