Słowińnska-Klencka Dorota, Sporny Stanisław, Klencki Mariusz, Lewińnski Andrzej
Department of Thyroidology, Institute of Endocrinology, Medical University of Łódz, Poland.
Endocr Pathol. 2004 Spring;15(1):65-75. doi: 10.1385/ep:15:1:65.
This study assessed the incidence of neoplasms, including malignant tumors, in lesions within the thyroid gland from which non-diagnostic biopsy aspirates were obtained. An auxiliary goal of the study was an evaluation of the diagnostic efficacy of repeated biopsy in cases when the first biopsy was non-diagnostic. Thus, results of 4603 fine-needle aspiration biopsies (FNABs) were submitted to histopathological verification. The verification revealed the rate of malignancy at 7.1% for non-diagnostic biopsies, i.e., significantly higher (p < 0.001) than that in cases FNAB-diagnosed as benign lesions (2.1%). Repeated biopsy, performed when inadequate material has been collected, seems to be less effective than the first biopsy (non-diagnostic specimens: 14.4% vs 8.9%; p < 0.01). The occurrence of neoplasms in the goiter was significantly higher (p < 0.0001) in patients with non-diagnostic first FNAB than in those with diagnostic one (50.7% vs 33.5%, p < 0.001). And again, in patients with two non-diagnostic FNABs, the occurrence of neoplasms was higher than that in patients with the second diagnostic cytology (63% vs 41.2%, p < 0.05). According to our data, patients with non-diagnostic FNAB results should be very carefully monitored, especially when the repeated biopsy is either non-diagnostic again or not performed at all.
本研究评估了从甲状腺病变中获取非诊断性活检吸出物的肿瘤（包括恶性肿瘤）发生率。该研究的一个辅助目标是评估首次活检为非诊断性时重复活检的诊断效果。因此，对4603例细针穿刺活检（FNAB）结果进行了组织病理学验证。验证结果显示，非诊断性活检的恶性率为7.1%，即显著高于FNAB诊断为良性病变的病例（2.1%，p<0.001）。当收集的材料不足时进行的重复活检似乎比首次活检效果差（非诊断性标本：14.4%对8.9%；p<0.01）。首次FNAB为非诊断性的患者中，甲状腺肿中肿瘤的发生率显著高于诊断性患者（50.7%对33.5%，p<0.001，p<0.0001）。同样，在两次FNAB均为非诊断性的患者中，肿瘤的发生率高于第二次细胞学诊断为阳性的患者（63%对41.2%，p<0.05）。根据我们的数据，FNAB结果为非诊断性的患者应受到非常仔细的监测，尤其是当重复活检再次为非诊断性或根本未进行时。
