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Abstract：
BACKGROUND: Thyroid fine-needle aspiration has traditionally been prepared using conventional smears (CS). Liquid-based preparations (LBP) have grown in popularity and yet, there is a lack of consensus about which method is superior. This review compared CS and LBP as an intervention in the management of thyroid nodules.
METHODS: Medline, EMBASE, Scopus and ClinicalTrials.gov were searched to locate relevant studies. Observational studies comparing CS and LBP of consecutive thyroid fine-needle aspirations were included. Two reviewers independently screened, extracted, and entered data. Double data extraction included the following outcomes: (1) the proportion of inadequate smears and (2) the proportion of indeterminate smears. Studies were also assessed for risk of bias and heterogeneity.
RESULTS: From 599 unique studies, title/abstract screening identified 136 studies, and full text screening identified 13 studies. The 13 studies included 24,307 fine-needle aspirations from 19,433 patients and had high clinical, methodological, and statistical heterogeneity with low risk of bias. For CS and LBP, a meta-analysis of 12 studies showed no difference in the proportion of inadequate smears (risk difference: -0.00; 95% confidence interval [CI]: -0.04-0.04); 13 studies showed no difference in the proportion of indeterminate smears (risk difference: -0.02; 95% CI: -0.05-0.01). Sensitivity analysis of studies with low risk of bias had similar results.
CONCLUSIONS: There is no difference between CS and LBP in the proportion of inadequate and indeterminate smears. Recommendations of one method over the other should be based on cost, feasibility, and accuracy, all of which require further study.
METHODS: Medline, EMBASE, Scopus and ClinicalTrials.gov were searched to locate relevant studies. Observational studies comparing CS and LBP of consecutive thyroid fine-needle aspirations were included. Two reviewers independently screened, extracted, and entered data. Double data extraction included the following outcomes: (1) the proportion of inadequate smears and (2) the proportion of indeterminate smears. Studies were also assessed for risk of bias and heterogeneity.
RESULTS: From 599 unique studies, title/abstract screening identified 136 studies, and full text screening identified 13 studies. The 13 studies included 24,307 fine-needle aspirations from 19,433 patients and had high clinical, methodological, and statistical heterogeneity with low risk of bias. For CS and LBP, a meta-analysis of 12 studies showed no difference in the proportion of inadequate smears (risk difference: -0.00; 95% confidence interval [CI]: -0.04-0.04); 13 studies showed no difference in the proportion of indeterminate smears (risk difference: -0.02; 95% CI: -0.05-0.01). Sensitivity analysis of studies with low risk of bias had similar results.
CONCLUSIONS: There is no difference between CS and LBP in the proportion of inadequate and indeterminate smears. Recommendations of one method over the other should be based on cost, feasibility, and accuracy, all of which require further study.
摘要：
背景：传统上使用常规涂片（CS）制备甲状腺细针抽吸术。液基制剂(LBP)越来越受欢迎，但关于哪种方法更优越，缺乏共识。这篇综述比较了CS和LBP作为甲状腺结节治疗的干预措施。
方法：Medline，EMBASE,搜索Scopus和ClinicalTrials.gov以查找相关研究。包括比较连续甲状腺细针穿刺的CS和LBP的观察性研究。两名审稿人独立筛选，提取,并输入数据。双重数据提取包括以下结果：（1）不充分涂片的比例和（2）不确定涂片的比例。研究还评估了偏倚和异质性的风险。
结果：从599项独特的研究中，标题/摘要筛选确定了136项研究，全文筛选确定了13项研究。这13项研究包括来自19,433名患者的24,307名细针穿刺，具有很高的临床，方法论,和统计异质性，偏倚风险低。对于CS和LBP，对12项研究进行的荟萃分析显示,不充分涂片的比例无差异(风险差异:-0.00;95%置信区间[CI]:-0.04~0.04);13项研究显示,不确定涂片的比例无差异(风险差异:-0.02;95%CI:-0.05~0.01).低偏倚风险研究的敏感性分析结果相似。
结论：CS和LBP在涂片不充分和不确定的比例上没有差异。一种方法优于另一种方法的建议应基于成本，可行性,和准确性，所有这些都需要进一步研究。
方法：Medline，EMBASE,搜索Scopus和ClinicalTrials.gov以查找相关研究。包括比较连续甲状腺细针穿刺的CS和LBP的观察性研究。两名审稿人独立筛选，提取,并输入数据。双重数据提取包括以下结果：（1）不充分涂片的比例和（2）不确定涂片的比例。研究还评估了偏倚和异质性的风险。
结果：从599项独特的研究中，标题/摘要筛选确定了136项研究，全文筛选确定了13项研究。这13项研究包括来自19,433名患者的24,307名细针穿刺，具有很高的临床，方法论,和统计异质性，偏倚风险低。对于CS和LBP，对12项研究进行的荟萃分析显示,不充分涂片的比例无差异(风险差异:-0.00;95%置信区间[CI]:-0.04~0.04);13项研究显示,不确定涂片的比例无差异(风险差异:-0.02;95%CI:-0.05~0.01).低偏倚风险研究的敏感性分析结果相似。
结论：CS和LBP在涂片不充分和不确定的比例上没有差异。一种方法优于另一种方法的建议应基于成本，可行性,和准确性，所有这些都需要进一步研究。
