Castro M Regina, Gharib Hossein
Department of Medicine and Endocrinology, Stratton VA Medical Center, Albany, New York, USA.
Endocr Pract. 2003 Mar-Apr;9(2):128-36. doi: 10.4158/EP.9.2.128.
To provide an updated review of the current progress in, and the practice and pitfalls of, thyroid fine-needle aspiration (FNA) biopsy.
The medical literature on the topic was reviewed, and the current methods, advantages, and controversies concerning FNA biopsy of thyroid nodules are summarized.
Thyroid nodules are a common clinical problem, with an estimated prevalence ranging from 19 to 35%. Most thyroid cancers manifest as thyroid nodules; however, only a small fraction of all thyroid nodules harbor malignant disease. Certain clinical features increase the likelihood of malignant involvement, but the absence of such features does not exclude the possibility of cancer. Of all currently available methods of evaluating nodular thyroid disease, FNA biopsy has been found to have the greatest diagnostic accuracy, approaching 95%, and its widespread use has resulted in substantial cost savings and has allowed a much better selection of patients in need of surgical treatment. The procedure, however, has two major limitations: nondiagnostic yield and indeterminate results. The approach to the management of patients with thyroid nodules is summarized.
FNA is the most reliable and cost-effective method of distinguishing benign from suspicious or malignant thyroid nodules.
对甲状腺细针穿刺活检（FNA）的当前进展、实践及陷阱进行更新综述。
回顾了关于该主题的医学文献，并总结了甲状腺结节FNA活检的当前方法、优势及争议。
甲状腺结节是常见的临床问题，估计患病率在19%至35%之间。大多数甲状腺癌表现为甲状腺结节；然而，所有甲状腺结节中只有一小部分为恶性病变。某些临床特征会增加恶性病变的可能性，但缺乏这些特征并不能排除癌症的可能性。在目前所有评估甲状腺结节性疾病的方法中，FNA活检的诊断准确性最高，接近95%；其广泛应用已大幅节省成本，并能更好地筛选出需要手术治疗的患者。然而，该操作有两个主要局限性：非诊断性结果和不确定结果。总结了甲状腺结节患者的管理方法。
FNA是区分良性与可疑或恶性甲状腺结节最可靠且最具成本效益的方法。
