OBJECTIVE To evaluate the performance of core-needle biopsy (CNB) in thyroid using a cohort of patients in which it was used as first choice. METHODS Our institutional review board approved this retrospective study. We reviewed all CNB performed in our center over a period of 11 years. Ultrasound-guided CNBs were performed using a spring-loaded 18-gauge biopsy needle. We used a classification with four diagnostic categories for CNB results: insufficient, benign, follicular lesion (indeterminate), and malignant. Final diagnosis was based on surgical diagnosis or follow-up of at least 2 years in non-operated patients. RESULTS The study included 4412 CNB in 4112 nodules of 3768 patients, 300 of them repeated biopsies. Results were 148 insufficient (3.4%), 3706 benign (84%), 278 follicular lesions (6.3%), and 280 malignant (6.3%). Considering follicular lesion and malignancy CNB results as positive (both lead to the recommendation of surgery) sensitivity was 96% (CI 93.2-97.8) and specificity 93.7% (CI 92.9-94.5). Predictive positive value for a follicular lesion diagnosis was 12.2% and for a malignancy diagnosis, 98.6%. CNB likelihood ratio for malignancy of a malignant diagnosis was 841.9 (CI 315.8-2313.3), of a malignant/follicular lesion diagnosis was 23.4 (CI 20.1-27.3), and of a benign diagnosis was 0.04 (CI 0.02-0.07). Repeated CNB in 53 insufficient biopsies obtained 50 diagnostic results. Minor complications occurred in 2.2% of CNB, and major in four procedures (0.09%). CONCLUSIONS CNB in thyroid nodules is accurate and has few complications and a low rate of non-diagnostic and indeterminate diagnoses. It can be an alternative method when FNAC has poor performance. Repeating biopsy is useful after non-diagnostic biopsies. KEY POINTS • Core-needle biopsy of thyroid has a low ratio non-diagnostic and indeterminate results. • Core-needle biopsy results are highly reliable, especially benign results. • Complication rate of core-needle biopsy of thyroid is low.

中文翻译：

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甲状腺结节的穿刺针活检：性能，准确性和并发症。

目的使用一组首选的患者队列来评估甲状腺核心针穿刺活检（CNB）的性能。方法我们的机构审查委员会批准了这项回顾性研究。我们审查了我们中心11年来执行的所有CNB。超声引导的CNB使用弹簧加载的18号活检针进行。我们对CNB结果使用了四个诊断类别的分类：不足，良性，滤泡性病变（不确定）和恶性。最终诊断是基于手术诊断或非手术患者至少2年的随访。结果该研究包括3768名患者的4112个结节中的4412个CNB，其中300例进行了重复活检。结果为148个不足（3.4％），3706个良性（84％），278个滤泡性病变（6.3％）和280个恶性肿瘤（6.3％）。考虑到滤泡性病变和恶性肿瘤，CNB结果为阳性（均建议手术），敏感性为96％（CI 93.2-97.8），特异性为93.7％（CI 92.9-94.5）。滤泡病变诊断的预测阳性值为12.2％，恶性肿瘤诊断的预测阳性值为98.6％。CNB恶性诊断的恶性比为841.9（CI 315.8-2313.3），恶性/卵泡病变诊断为23.4（CI 20.1-27.3），良性诊断为0.04（CI 0.02-0.07）。在53例活检不足的情况下重复进行CNB可获得50例诊断结果。轻微并发症发生在CNB的2.2％，主要发生在四个过程中（0.09％）。结论甲状腺结节中的CNB准确，并发症少，非诊断性和不确定性诊断率低。当FNAC性能不佳时，它可以作为一种替代方法。在非诊断性活检后，重复活检很有用。要点•甲状腺的中心针活检具有较低的不确定性和不确定性结果。•芯针活检结果高度可靠，尤其是良性结果。•甲状腺的核心针活检的并发症发生率低。