Menéndez Torre Edelmiro, Pineda Arribas Javier, Martínez de Esteban Juan Pablo, López Carballo María Teresa, de Miguel Concepción, Salvador Pilar
Unidad de Patología Tiroidea, Hospital de Navarra y Hospital Virgen del Camino, Servicio Navarro de Salud, Pamplona, Spain.
Acta Cytol. 2007 Nov-Dec;51(6):850-2. doi: 10.1159/000325859.
To assess the value of reaspiration cytology in benign nodular thyroid disease.
We prospectively studied 400 patients (365 women, 35 men) aged 46 years (18-89) with nodular thyroid disease and initial benign fine needle aspiration cytology (FNAC). Reaspiration of the same nodule was performed in a median follow-up time of 14 months (6-18).
Repeat FNAC was benign in 346 patients (86.5%), insufficient for diagnosis in 42 (10.5%), suspicious in 16 (2.5%) and malignant in 2 (0.5%). All diagnostic changes to suspicious malignant cytology took place in patients with solitary nodules. Surgery confirmed thyroid cancer in the 2 patients with malignant cytology, in 5 of 10 patients with suspicious cytology and in none of 39 patients with benign cytology who underwent surgery for other reasons. Clinical changes (size increase or local symptoms) were not related to changes in cytologic diagnosis after a second aspiration, nor with the results of the biopsy.
Repeat aspiration cytology of thyroid nodules may correct initial false negative results because of cytologic misdiagnosis, occurring in 1.75% of patients, whereas clinical changes did not contribute to diagnosis change. Repeat aspiration cytology is recommended in all patients with nodular goiter.
评估再次穿刺细胞学检查在良性甲状腺结节疾病中的价值。
我们对400例年龄在46岁（18 - 89岁）患有甲状腺结节疾病且初次细针穿刺细胞学检查（FNAC）为良性的患者（365名女性，35名男性）进行了前瞻性研究。在中位随访时间14个月（6 - 18个月）时对同一结节进行再次穿刺。
重复FNAC结果为良性的有346例患者（86.5%），诊断不足的有42例（10.5%），可疑的有16例（2.5%），恶性的有2例（0.5%）。所有诊断变为可疑恶性细胞学的情况均发生在单发结节患者中。手术证实2例恶性细胞学患者患有甲状腺癌，10例可疑细胞学患者中有5例患有甲状腺癌，39例因其他原因接受手术的良性细胞学患者中无一例患有甲状腺癌。临床变化（大小增加或局部症状）与二次穿刺后细胞学诊断的变化无关，也与活检结果无关。
甲状腺结节重复穿刺细胞学检查可能纠正因细胞学误诊导致的初始假阴性结果，这种情况发生在1.75%的患者中，而临床变化对诊断改变没有作用。建议对所有结节性甲状腺肿患者进行重复穿刺细胞学检查。
