甲状腺细针穿刺结果不确定结节中恶性肿瘤的患病率
Prevalence of malignancy within cytologically indeterminate thyroid nodules.
作者信息
Miller Barbara, Burkey Shelby, Lindberg Guy, Snyder William H, Nwariaku Fiemu E
机构信息
Department of Surgery, University of Texas Southwestern Medical Center, Department of Surgery, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-9156, USA.
出版信息
Am J Surg. 2004 Nov;188(5):459-62. doi: 10.1016/j.amjsurg.2004.07.006.
BACKGROUND
The optimal management of cytologically indeterminate thyroid nodules is controversial given the variable malignancy rates reported in this patient population. We examined the prevalence of malignancy within cytologically indeterminate follicular thyroid lesions in an attempt to predict malignancy based on cytologic features.
METHODS
Cytopathology reports obtained after fine-needle aspiration biopsy (FNAB) examination of indeterminate follicular thyroid lesions were examined over a 4-year period. The prevalence of malignancy on final histology was determined in 4 indeterminate cytologic categories.
RESULTS
A total of 107 records were available (91 women, 16 men). The mean patient age was 45.4 +/- 16 years. Forty-eight patients (45%) underwent surgery and had histopathologic diagnosis, while 57 patients did not have surgery. The prevalence of malignancy in patients who underwent thyroidectomy was 42% (20 of 48).
CONCLUSIONS
The high prevalence of malignancy within indeterminate follicular lesions may necessitate thyroidectomy for patients with indeterminate follicular lesions on FNAB examination.
背景
鉴于该患者群体中报道的恶性率各不相同，对于甲状腺细针穿刺活检结果为不确定的甲状腺结节，最佳治疗方案存在争议。我们研究了甲状腺滤泡性病变细针穿刺活检结果为不确定时的恶性肿瘤患病率，试图根据细胞学特征预测恶性肿瘤。
方法
对4年间通过细针穿刺活检（FNAB）检查甲状腺滤泡性病变获得的细胞病理学报告进行研究。确定了4种不确定细胞学分类的最终组织学上的恶性肿瘤患病率。
结果
共有107份记录（91名女性，16名男性）。患者平均年龄为45.4±16岁。48名患者（45%）接受了手术并获得组织病理学诊断，而57名患者未接受手术。接受甲状腺切除术的患者中恶性肿瘤患病率为42%（48例中的20例）。
结论
对于细针穿刺活检检查发现滤泡性病变不确定的患者，滤泡性病变中较高的恶性肿瘤患病率可能需要进行甲状腺切除术。
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