甲状腺乳头状癌滤泡变体：细针穿刺细胞学检查的诊断局限性
Follicular variant of papillary thyroid carcinoma: diagnostic limitations of fine needle aspiration cytology.
作者信息
Shih Shyang-Rong, Shun Chia-Tung, Su Deng-Huang, Hsiao Yung-Lien, Chang Tien-Chun
机构信息
Department of Internal Medicine, Far-Eastern Memorial Hospital, Taipei, Taiwan, ROC.
出版信息
Acta Cytol. 2005 Jul-Aug;49(4):383-6. doi: 10.1159/000326170.
OBJECTIVE
To study the diagnostic sensitivity and specificity of fine needle aspiration cytology (FNAC) offollicular variant of papillary thyroid carcinoma (FVPTC).
STUDY DESIGN
The study group consisted of 390 papillary thyroid carcinoma (PTC) cases diagnosed histologically with thyroidectomy specimens. The FNAC and histopathologic classification were compared in terms of the appearance of FVPTC and non-FVPTC statistically with the chi squared test. Also, several features of the cytologic smears of FVPTC were reviewed.
RESULTS
Twelve of the 390 PTC cases were classified as FVPTC histologically. Five of the 12 cases were also reported as FVPTC in the diagnosis by FNAC and the other 7 as the usual type of PTC (UTPTC). There was 1 case classified as UVPTC histologically but FVPTC cytologically. If we use histologic diagnosis as the gold standard, the sensitivity and specificity of FNAC diagnosis of FVPTC were 42% and 83%, respectively.
CONCLUSION
FNAC may be a good tool for diagnosing PTC, but it is unreliable to differentiate between FVPTC and UTPTC.
目的
研究细针穿刺细胞学检查（FNAC）对甲状腺乳头状癌滤泡变体（FVPTC）的诊断敏感性和特异性。
研究设计
研究组由390例经甲状腺切除标本组织学诊断为甲状腺乳头状癌（PTC）的病例组成。采用卡方检验对FVPTC和非FVPTC的FNAC及组织病理学分类在外观方面进行统计学比较。此外，还回顾了FVPTC细胞学涂片的几个特征。
结果
390例PTC病例中有12例组织学上被分类为FVPTC。12例中的5例在FNAC诊断中也被报告为FVPTC，另外7例被报告为普通类型的PTC（UTPTC）。有1例组织学上分类为UTPTC但细胞学上为FVPTC。如果以组织学诊断作为金标准，FNAC诊断FVPTC的敏感性和特异性分别为42%和83%。
结论
FNAC可能是诊断PTC的一种好工具，但区分FVPTC和UTPTC并不可靠。
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