A Comparison of the Results of Monolayer versus Smear Cytopreparatory Techniques for Fine-Needle Aspiration in 100 Consecutive Patients Undergoing Thyroidectomy: A Surgeon's Perspective

Abstract

OBJECTIVE: To compare thyroid fine-needle aspiration (FNA) using monolayer (MT) versus conventional smear (CS) cytopreparatory techniques with final histology. STUDY DESIGN: Retrospective review of 100 consecutive thyroidectomies. SETTING: Tertiary care university affiliated medical center. RESULTS: 26% of MT aspirates were inadequate compared with 3% of CS aspirates ( P < 0.05). The negative predictive values for MT and CS were 86% and 100%, respectively. The positive predictive values for MT and CS were 69% and 90%, respectively. CONCLUSIONS: Fewer inadequate specimens will be obtained with CS than with MT. A clinician performing FNA can obtain adequate specimens at a rate comparable to that of a hospital-based cytopathologist. SIGNIFICANCE: CS provides greater assurance to the patient and the surgeon that a thyroid nodule with a FNA interpreted as benign can be observed. A higher percentage of patients with malignant tumor will receive thyroidectomy with the use of CS technique for FNA. EBM rating: B-3. (Otolaryngol Head Neck Surg 2004;131:964–7.)