Emmrich P, Gauer G, Gauer J, Mättig H, Rosenkranz M
Institut für Pathologie, Universität Leipzig.
Zentralbl Chir. 2001 Apr;126(4):267-72. doi: 10.1055/s-2001-14798.
We compare the results of fine-needle aspiration cytology of the thyroid gland with postoperative histological findings in 533 patients with thyroidectomy operated on between 1987 and 1994. The classification of the cytological preparations followed the proposal of Weiss and Pilz [35] with the groups 0-IV. In group 0 the most frequent findings were cystic changes in multinodular goitre or malpuncture, respectively. The groups I and II contained cases with multinodular goitre, thyroiditis and follicular adenomas, but 4 carcinomas too. The group III comprised particularly follicular adenomas and carcinomas (8 cases). Both cases in group IV were carcinomas. In group III (cytologic group with suspicious findings) there were 65 cases with false positive results of the cytologic investigation resulting in a specificity of 86.4%. 4 out of 14 thyroid carcinomas could not be detected by cytologic preparations corresponding to a sensitivity of 71.4% for carcinomas. The false negative rate for thyroid carcinomas in group II was caused by regression areas in the center of the tumors (3 cases) as well as one microcarcinoma. Preoperative fine-needle aspiration cytology of the thyroid gland reduces the number of patients operated on for multinodular goitre or cold nodules especially in cases suspicious of carcinoma.
我们比较了1987年至1994年间接受甲状腺切除术的533例患者的甲状腺细针穿刺细胞学检查结果与术后组织学检查结果。细胞学标本的分类遵循Weiss和Pilz[35]的提议,分为0-IV组。在0组中,最常见的发现分别是多结节性甲状腺肿的囊性改变或穿刺不当。I组和II组包含多结节性甲状腺肿、甲状腺炎和滤泡性腺瘤病例,但也有4例癌。III组主要包括滤泡性腺瘤和癌(8例)。IV组的2例均为癌。在III组(细胞学检查结果可疑的组)中,有65例细胞学检查结果为假阳性,特异性为86.4%。14例甲状腺癌中有4例通过细胞学标本未能检测到,癌的敏感性为71.4%。II组甲状腺癌的假阴性率是由肿瘤中心的退行性区域(3例)以及1例微癌引起的。术前甲状腺细针穿刺细胞学检查减少了因多结节性甲状腺肿或冷结节而接受手术的患者数量,尤其是在怀疑为癌的病例中。