Chow L S, Gharib H, Goellner J R, van Heerden J A
Division of Endocrinology, Metabolism, Nutrition, and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Thyroid. 2001 Dec;11(12):1147-51. doi: 10.1089/10507250152740993.
Approximately 10% to 20% of thyroid biopsies by fine-needle aspiration (FNA) are nondiagnostic. The management of thyroid nodules in which FNA is nondiagnostic remains controversial because few studies have addressed this issue. We retrospectively reviewed the medical records of 153 patients with nondiagnostic FNAs of the thyroid performed in 1994. Sixty patients had reaspiration biopsies performed. Thirty-seven specimens (62%) were diagnostic and 23 (38%) remained nondiagnostic. Of the 27 patients who had a thyroid operation, 10 (37%) had a malignancy. Preoperative information about physical examination, ultrasound imaging, or nondiagnostic FNA did not predict outcome. Nondiagnostic FNAs of the thyroid may be associated with a high probability of thyroid malignancy. Nondiagnostic FNAs should not be considered benign. Reaspiration followed by selective surgical treatment is recommended.
约10%至20%的甲状腺细针穿刺活检（FNA）结果无法诊断。FNA结果无法诊断的甲状腺结节的处理仍存在争议，因为很少有研究涉及这一问题。我们回顾性分析了1994年进行的153例FNA结果无法诊断的甲状腺患者的病历。60例患者接受了再次穿刺活检。37份标本（62%）结果可诊断，23份（38%）仍无法诊断。在接受甲状腺手术的27例患者中，10例（37%）患有恶性肿瘤。术前体格检查、超声成像或FNA无法诊断的信息均不能预测结果。甲状腺FNA无法诊断可能与甲状腺恶性肿瘤的高概率相关。FNA无法诊断不应被视为良性。建议再次穿刺活检后进行选择性手术治疗。
