Background: Compared to syringe needles, stylet needles are hypothesized to enhance the specimen adequacy of thyroid fine needle aspiration (FNA) by potentially minimizing blood contamination. However, this hypothesis lacks robust evidence for substantiation. Additionally, the substantially higher cost of stylet needles (often several orders of magnitude greater than syringe needles) raises concerns about increased procedural expenses. This study aimed to compare the outcomes of thyroid FNA using stylet versus syringe needles in a large cohort.

Methods: This retrospective analysis included 4793 FNA procedures (2088 using stylet needles and 2705 using syringe needles) performed by five operators. The primary outcome was specimen adequacy. Secondary outcomes included sensitivity, specificity, diagnostic accuracy, positive predictive value (PPV), and negative predictive value (NPV).

Results: No significant differences were found between stylet and syringe needle FNA for specimen adequacy (85.34% vs. 87.13%), sensitivity (95.24% vs. 96.99%), specificity (78.57% vs. 78.05%), diagnostic accuracy (93.96% vs. 95.07%), PPV (98.16% vs. 97.52%), or NPV (57.89% vs. 74.42%). Performance metrics for both methods were also not significantly different within each operator's data.

Conclusion: This study found no significant benefit of stylet needles over syringe needles regarding specimen adequacy or diagnostic yield in thyroid FNA.

Clinical trial number: Not applicable.

Keywords: Adequacy; Fine-needle aspiration; Needle; Thyroid nodule.

© 2025. The Author(s).

背景：

与注射器针头相比，导丝针被认为可以通过减少血液污染来提高甲状腺细针抽吸（FNA）的标本质量。然而，这一假设缺乏有力证据的支持。此外，导丝针的成本通常远高于注射器针头（有时高出几个数量级），这引发了关于程序成本增加的关注。本研究旨在通过一个大型队列对比使用导丝针与注射器针进行甲状腺FNA的结果。

方法：

这项回顾性分析包括了5名操作者进行的4793例FNA手术（其中2088例使用导丝针，2705例使用注射器针）。主要结果指标是标本质量。次要结果指标包括敏感性、特异性、诊断准确性、阳性预测值（PPV）和阴性预测值（NPV）。

结果：

导丝针与注射器针FNA在标本质量（85.34% vs 87.13%）、敏感性（95.24% vs 96.99%）、特异性（78.57% vs 78.05%）、诊断准确性（93.96% vs 95.07%）、阳性预测值（98.16% vs 97.52%）或阴性预测值（57.89% vs 74.42%）方面没有显著差异。两种方法在每位操作者的数据中表现指标也没有显著不同。

结论：

本研究发现，在甲状腺FNA中，导丝针并不比注射器针提供更优的标本质量和诊断产量。

临床试验编号：不适用。

关键词：
质量；细针抽吸；针头；甲状腺结节。