A Comparative Analysis of Liquid-Based Cytology and Conventional Smears in Fine-Needle Aspirates of Thyroid Lesions

Malti K Maurya; Rita Yadav; Madhu Kumar; Hitendra P Singh; Anand Mishra; Madhu Mati Goel

doi:10.7759/cureus.45353

A Comparative Analysis of Liquid-Based Cytology and Conventional Smears in Fine-Needle Aspirates of Thyroid Lesions

Cureus. 2023 Sep 16;15(9):e45353. doi: 10.7759/cureus.45353. eCollection 2023 Sep.

Authors

Malti K Maurya¹, Rita Yadav², Madhu Kumar¹, Hitendra P Singh³, Anand Mishra⁴, Madhu Mati Goel^{5

1}

Affiliations

¹ Department of Pathology, King George's Medical University, Lucknow, IND.
² Department of Pathology, Prasad Institute of Medical Sciences, Lucknow, IND.
³ Department of Otolaryngology, Head and Neck Surgery, King George's Medical University, Lucknow, IND.
⁴ Department of Endocrine Surgery, King George's Medical University, Lucknow, IND.
⁵ Department of Pathology and Laboratory Medicine/Histopathology Cytopathology, Immunohistochemistry and Molecular Pathology, Medanta Hospital, Lucknow, IND.

Abstract

Background Palpable nodules in the thyroid are present in 4-7% of the general population. Fine-needle aspiration cytology is a safe and cost-effective method of choice for evaluating thyroid nodules. Aspirated samples can be manually spread directly onto the slide and stained in the conventional smear method. The liquid-cased cytology method has been recently introduced, which is an automated machine-based method, yielding a single slide with a clean background and greater preservation of cells and consuming less time for screening. This study aimed to compare the cytomorphological features and diagnostic accuracy of conventional smears and liquid-based cytology smears. Methodology This prospective study comprised 250 cases of thyroid lesions. Fine-needle aspiration cytology using conventional smears and liquid-based cytology smears was reported per the Bethesda system of reporting thyroid cytopathology. Detailed cytomorphological features were evaluated and compared in both techniques. Results The cellularity of conventional smears was significantly higher for scores 2+ and 3+ than paired liquid-based cytology smears (paired t-test, p < 0.001). The overall diagnostic efficacy of conventional smears and liquid-based cytology smears was equivalent in the majority of cases (n = 171, 68.4%). Conventional smears were better than liquid-cased cytology smears in 34 (13.6%) cases, and liquid-based cytology smears were better than conventional smears in eight (3.2%) cases. Liquid-based cytology smears showed a higher unsatisfactory rate compared to conventional Smears (15.6% vs. 5.2%). The sensitivity and specificity of conventional smears were 84.6% and 94.4%, respectively, compared to 68.7% and 92.4%, respectively, of liquid-based cytology smears. Conclusions Conventional smears are a cost-effective and easy method for diagnosing thyroid nodules. Liquid-based cytology smears can be used in association with conventional smears to enhance the accuracy of the evaluation of malignant thyroid nodules.

Keywords: colloid goiter; conventional smear cytology; liquid-based cytology; lymphocytic thyroiditis; surepath; thyroid lesion.

Grants and funding

An intramural faculty research grant from the Research Cell, King George’s Medical University, Lucknow, Uttar Pradesh, India.