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甲状腺结节的细胞组织学相关性

Cytohistologic correlation of thyroid nodules.

作者信息

Mazeh Haggi, Beglaibter Nahum, Prus Diana, Ariel Ilana, Freund Herbert R

机构信息

Department of Surgery, Hadassah Hebrew University Medical Center, Mount Scopus 24035 Jerusalem, Israel.

出版信息

Am J Surg. 2007 Aug;194(2):161-3. doi: 10.1016/j.amjsurg.2006.10.025.

Abstract

BACKGROUND

Fine-needle aspiration (FNA) is widely used as a diagnostic tool to assess thyroid nodules. This study correlates FNA cytology results with surgical pathologic findings.

METHODS

All thyroidectomies performed between 1994 and 2004 were reviewed, identifying 242 patients. Data were obtained for FNA diagnosis, demographics, findings on ultrasound, and histologic findings.

RESULTS

Among 89 patients with a carcinoma on FNA, 89% of cases were verified on final histopathology. Of 78 patients with "follicular lesion" on FNA, only 36% of cases were verified to be malignant at surgery. Only 13% of the 75 cases diagnosed as benign, mostly colloid nodules, on FNA were found to have a carcinoma on histopathology.

CONCLUSION

A cytologic diagnosis of papillary carcinoma has a highly predictive of thyroid cancer. When dealing with follicular lesions the predictive value of FNA drops considerably. However, we found a 13% false positive result to occur in FNA declared benign lesions.

摘要

背景

细针穿刺抽吸活检(FNA)作为评估甲状腺结节的诊断工具被广泛应用。本研究将FNA细胞学结果与手术病理结果进行关联。

方法

回顾了1994年至2004年间进行的所有甲状腺切除术,确定了242例患者。获取了FNA诊断、人口统计学、超声检查结果及组织学检查结果的数据。

结果

在FNA诊断为癌的89例患者中,89%的病例在最终组织病理学检查中得到证实。在FNA诊断为“滤泡性病变”的78例患者中,只有36%的病例在手术中被证实为恶性。在FNA诊断为良性(大多为胶样结节)的75例病例中,只有13%在组织病理学检查中发现有癌。

结论

乳头状癌的细胞学诊断对甲状腺癌具有高度预测性。在处理滤泡性病变时,FNA的预测价值大幅下降。然而,我们发现FNA诊断为良性的病变中有13%出现假阳性结果。

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