Korean J Otorhinolaryngol-Head Neck Surg.  2017 Jun;60(6):308-313. 10.3342/kjorl-hns.2017.00136.

The Impact of Thyroid Nodule Size and Fine-Needle Aspiration Biopsy Result on the Risk of Malignancy in the Patients Who Underwent Thyroidectomy

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul, Korea. diakonos@korea.ac.kr

Abstract

BACKGROUND AND OBJECTIVES
The frequency of ultrasonography and cytological examinations for thyroid nodules has increased. But the efficacy of fine needle aspiration biopsy varies according to the size of the nodules. The study aimed to identify the effect of thyroid nodule size on malignancy. SUBJECTS AND METHOD: The medical records of patients who underwent total or hemithryoidectomy in a single tertiary hospital were retrospectively analyzed. A total of 204 nodules were obtained from 193 patients who underwent fine needle aspiration biopsy before thyroid surgery. After each nodule was classified by size, the results of the fine needle aspiration test and risk of the final diagnosis were evaluated using logistic regression analysis.
RESULTS
The average size of 204 Bethesda class 2 (benign) nodules was 2.99 cm, which was larger than those of other classes (p<0.05). In the final histopathologic diagnosis, there was a difference in size between benign (2.41 cm) and malignant nodules (1.23 cm) (p<0.05). In addition, a logistic regression analysis showed that the nodules below 2.0 cm in size showed an odd ratio of 7.81, compared to the nodules larger than 2.0 cm (p<0.05).
CONCLUSION
According to the results of this study, malignancy was higher when the thyroid nodule was less than 2 cm. Therefore, a careful observation is needed for nodules less than 2 cm for which fine needle aspiration biopsy would be recommended. Conversely, it is necessary to reconsider the diagnostic surgery for nodules larger than 2 cm.

Keyword

Biopsy; Fine-needle; Thyroid gland; Thyroid neoplasms; Thyroid nodule

MeSH Terms

Biopsy
Biopsy, Fine-Needle*
Diagnosis
Humans
Logistic Models
Medical Records
Methods
Retrospective Studies
Tertiary Care Centers
Thyroid Gland*
Thyroid Neoplasms
Thyroid Nodule*
Thyroidectomy*
Ultrasonography
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