diagnostic accuracy of fine needle aspiration for solitary and multiple thyroid nodules in a tertiary care center

Background: thyroid nodules are common in clinical practice. they are usually benign, but malignancy must be ruled out. fine needle aspiration (fna) biopsy of the thyroid is a rapid and cost-effective procedure in the initial evaluation of a thyroid nodule, but its resultsmaybe inaccurate in 10% to 30% of cases. this prospective observational study was conducted to determine the prevalence of thyroid cancer, its related findings, and the diagnostic accuracy of preoperative fna in a tertiary care center. methods:we prospectively studied the medical records of 345 subjects, whounderwent thyroid resection in the university hospital setting over a 4-year period. age, gender, fna and pathologic reports, and whether the lesion was multinodular or a solitary nodule were determined. results: the sensitivity and specificity of fna were 64.96% and 62.76%, respectively. the positive predictive value of the test for the diagnosis of malignant nodules was 59.30% and its negative predictive value was 68.20%. in 63.5% of the patients, the preoperative fna matched the surgical histopathology results. the presence of multinodular goiter was an important risk factor for thyroid malignancy. fifty-two subjects had papillary microcarcinoma and the rate of aggressive behavior was considerable in this group. conclusions: although fine needle aspiration biopsy is the most important step in the workup of the thyroid nodules, it may miss a significant number of malignant lesions. therefore, there is a mandatory need to evolve other clinical and laboratory adjuncts, which assists the clinicians with the interpretation of fna more accurately.