Illouz Frédéric, Rodien Patrice, Saint-André Jean Paul, Triau Stéphane, Laboureau-Soares Sandrine, Dubois Séverine, Vielle Bruno, Hamy Antoine, Rohmer Vincent
Département d'Endocrinologie, CHU d'Angers, Angers, France.
Eur J Endocrinol. 2007 Mar;156(3):303-8. doi: 10.1530/EJE-06-0616.
The usefulness of repeated fine-needle cytology (FNC) in thyroid nodules with benign cytology remains unknown. We analyzed the relevance of repeated FNC to detect suspicious or malignant (S/M) cytologies and carcinomas.
A retrospective study (1983-2004) was conducted in our endocrinology department.
We reviewed the reports of 895 adequate FNC performed in 298 patients (298 nodules) during a mean follow-up of 5 years. We compared the nodules with at least one suspicious or malignant FNC (S/M nodules) with nodules with repeatedly benign (RB) FNC (RB nodules).
Among the nodules with initial benign cytology, we found 35 nodules with one or more later suspicious or malignant results. The interval between the first FNC and the first S/M FNC was 2.9 years. The probability for a nodule to have a repeated benign FNC decreases with time and with the number of FNC. We did not find any clinical or ultrasonographic characteristics related to an S/M cytology. Seven cancers were detected by the second or the third FNC with S/M results. The proportion of cancers among S/M nodules was similar when S/M cytology appears during the first, the second, or the third FNC.
We suggest to repeat FNC up to three adequate samples in the follow-up of thyroid nodules so as not to miss the presence of malignant neoplasm.
重复细针穿刺细胞学检查（FNC）在细胞学检查为良性的甲状腺结节中的作用尚不清楚。我们分析了重复FNC对检测可疑或恶性（S/M）细胞学结果及癌的相关性。
在我们内分泌科进行了一项回顾性研究（1983 - 2004年）。
我们回顾了298例患者（298个结节）在平均5年随访期间进行的895次充分FNC的报告。我们将至少有一次可疑或恶性FNC结果的结节（S/M结节）与多次为良性（RB）FNC结果的结节（RB结节）进行了比较。
在最初细胞学检查为良性的结节中，我们发现35个结节后来有一次或多次可疑或恶性结果。首次FNC与首次S/M FNC之间的间隔为2.9年。结节获得重复良性FNC结果的概率随时间和FNC次数的增加而降低。我们未发现与S/M细胞学相关的任何临床或超声特征。通过第二次或第三次FNC检测到7例癌症，其结果为S/M。当S/M细胞学结果出现在第一次、第二次或第三次FNC时，S/M结节中的癌症比例相似。
我们建议在甲状腺结节随访中重复进行FNC，最多获取三次充分样本，以免漏诊恶性肿瘤。
