Role of FNAB in the management of thyroid nodules

Indication to surgical treatement for thyroid nodules still rapresents a relevant clinical dilemma. With this regard, on a consecutive series of 434 thyroidectomies carried out in the last 3 years, the role of Fine Needle Aspiration Biopsy (FNAB) on 139 cases has been statistically evaluated. All cytologic diagnoses have been classified in three subsets: malignant [group 1]; suspect (follicular or Hurtle cell pro - liferation ) [group 2]; benign [group 3]. Our data confirm previous observations about the high specificity of FNAB in case of diagnosis of malignancy (97.6 %). On the other hand 51.6 % of our cases are included in group 2; only 31.9 % of these cases have shown a postoperative diagno - sis of malignancy, following a suspect at FNAB. In this study, the sensibility of FNAB has been calculated inclu - ding among positive results the cytologic diagnoses of group 1+group 2: the resulting figure of 87.3% weighes the impact of FNAB on our surgical decision process. FNAB plays a crucial role in the management of nodular diseases of the thyroid, even if its overall value is limited by the burden of suspect cytologic diagnoses. In our hands, the integra - tion of FNAB results with all relevant clinical data has undoubtedly contributed to increase the portion of thyroi - dectomies carried out for cancer, from 12.8% of our histo - rical series to 23.2 % of the last 3 years.