Baloch Zubair W, LiVolsi Virginia A
Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania 19103, USA.
Endocr Pract. 2004 May-Jun;10(3):234-41. doi: 10.4158/EP.10.3.234.
To present a review of the traditional and more recent techniques and applications of thyroid fine-needle aspiration biopsy.
We describe the cytologic features and differential diagnoses of various thyroid lesions, outline recommendations for diagnostic categories, and discuss new techniques that have shown some promise in the diagnosis of thyroid nodule fine-needle aspiration specimens.
Fine-needle aspiration biopsy of the thyroid has proved to be an excellent diagnostic tool in the initial management of thyroid nodules. Numerous studies have shown its high sensitivity and specificity in diagnosing malignant tumors of the thyroid, especially papillary thyroid carcinoma. As with other diagnostic tests, however, its effectiveness is highly dependent on the expertise of the operator performing the procedure and the adequacy of the specimen for interpretation of the cytomorphologic features. On-site evaluation of thyroid specimens promotes adequate specimen sampling and reduces the incidence of nondiagnostic specimens. Diagnostic reports on thyroid fine-needle aspiration should include patient demographics and pertinent clinical history, site and size of the thyroid nodule, mode of aspiration, number of needle passes, assessment of specimen adequacy, diagnosis, and recommendations. Although immunohistochemical and molecular markers have received considerable attention recently, additional studies are needed before they can be used to separate benign from malignant follicular thyroid lesions.
Overall, fine-needle aspiration biopsy of thyroid nodules has proved to be sensitive, specific, and well accepted by patients because of minimal discomfort and complications.
对甲状腺细针穿刺活检的传统及最新技术与应用进行综述。
我们描述各种甲状腺病变的细胞学特征及鉴别诊断，概述诊断分类的建议，并讨论在甲状腺结节细针穿刺标本诊断中显示出一定前景的新技术。
甲状腺细针穿刺活检已被证明是甲状腺结节初始管理中的一种出色诊断工具。众多研究表明其在诊断甲状腺恶性肿瘤，尤其是乳头状甲状腺癌方面具有高敏感性和特异性。然而，与其他诊断测试一样，其有效性高度依赖于实施该操作的操作人员的专业知识以及用于解释细胞形态学特征的标本的充分性。甲状腺标本的现场评估可促进标本的充分采样并降低非诊断性标本的发生率。甲状腺细针穿刺的诊断报告应包括患者人口统计学和相关临床病史、甲状腺结节的部位和大小、穿刺方式、穿刺针数、标本充分性评估、诊断及建议。尽管免疫组织化学和分子标志物最近受到了相当多的关注，但在它们可用于区分甲状腺滤泡性病变的良恶性之前，还需要更多研究。
总体而言，甲状腺结节细针穿刺活检已被证明具有敏感性、特异性，且因不适和并发症极少而被患者广泛接受。
