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. 2022 Feb 28;37(1):159–169. doi: 10.3803/EnM.2021.1299

Table 4.

Diagnostic Performance of Thyroid Core Needle Biopsy and Fine Needle Aspiration Cytology for the Diagnosis of Malignancy, Malignancy/NIFTP, and Surgical Diseases

Outcomes CNB (n=429) FNA (n=666) P value
Analysis 1a Malignant Benign+NIFTP Malignant Benign+NIFTP
 Category V–VI 240 0 489 1
 Category I–IV 72 117 67 109
 Diagnostic performance Incidence 95% CI Incidence 95% CI
  Disease prevalence 55.9% 49.1–63.5 73.4% 67.1–80.0 <0.001
  Sensitivity 76.9% 71.8–81.5 88.0% 85.0–90.5 0.089
  Specificity 100% 96.9–100.0 99.1% 95.0–100.0 0.945
  PPV 100% 100.0 99.8% 98.6–100.0 0.979
  NPV 61.9% 57.0–66.6 61.9% 56.5–67.1 0.997
  Accuracy 83.2% 79.3–86.6 89.8% 87.2–92.0 0.256
Analysis 2b Malignant+NIFTP Benign Malignant+NIFTP Benign P value
 Category IV–VI 318 70 506 13
 Category I–III 9 32 57 90
 Diagnostic performance Incidence 95% CI Incidence 95% CI
  Disease prevalence 76.2% 68.2–85.0 84.5% 77.7–91.8 0.137
  Sensitivity 97.2% 94.8–98.7 89.9% 87.1–92.2 0.271
  Specificity 31.4% 22.5–41.3 87.4% 79.4–93.1 <0.001
  PPV 82.0% 79.9–80.2 97.5% 95.9–98.5 0.015
  NPV 78.0% 63.7–87.8 61.2 55.0–67.1 0.237
  Accuracy 81.6% 77.6–85.1 89.5% 86.9–91.7 0.170
Analysis 3c Neoplastic (surgical disease) Non-neoplastic Neoplastic (surgical disease) Non-neoplastic P value
 Category IV–VI 381 7 517 2
 Category I–III 16 25 78 69
 Diagnostic performance Incidence 95% CI Incidence 95% CI
  Disease prevalence 88.8% 80.1–98.2 77.6% 71.1–84.6 0.046
  Sensitivity 96.0% 93.5–97.7 86.9% 83.9–89.5 0.141
  Specificity 78.1% 60.0–90.7 97.2% 90.2–99.7 0.349
  PPV 98.2% 96.6–99.1 99.6% 98.5–99.9 0.832
  NPV 61.0% 48.3–72.3 46.9% 41.7–52.2 0.261
  Accuracy 94.6% 92.1–96.6 88.0% 85.3–90.4 0.259

NIFTP, noninvasive follicular thyroid neoplasm with papillary-like nuclear feature; CNB, core needle biopsy; FNA, fine needle biopsy; CI, confidence interval; PPV, positive predictive value; NPV, negative predictive value.

a

Categories V and VI were considered diagnostic-positive results for malignancy. Diagnostic performance was evaluated for the differentiating malignancy from nonmalignant lesions including NIFTP;

b

Categories IV, V and VI were considered diagnostic-positive results for malignancy and NIFTP. Diagnostic performance was evaluated for the differentiating malignancy and NIFTP from benign lesions;

c

Categories IV, V and VI were considered diagnostic-positive results for surgical diseases. Diagnostic performance was evaluated for the differentiating surgical diseases (neoplasms) from non-neoplastic lesions.