Richards Melanie L, Bohnenblust Elizabeth, Sirinek Kenneth, Bingener Juliane
Department of Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA.
Am J Surg. 2008 Sep;196(3):398-402. doi: 10.1016/j.amjsurg.2007.10.017. Epub 2008 Jun 16.
Nondiagnostic fine-needle aspiration biopsy (ND-FNAB) of the thyroid leads to unnecessary thyroidectomy. The aims of this study were as follows: (1) to determine the risk of malignancy in ND-FNABs, and (2) to evaluate factors that may identify patients at risk for a ND-FNAB.
A total of 241 patients who underwent FNAB and thyroidectomy were evaluated for factors associated with a ND-FNAB.
A total of 215 women and 26 men underwent FNAB and thyroidectomy. ND-FNAs occurred in 51 of 241 (21%) patients. Ultrasound guidance did not reduce the likelihood of a ND biopsy. Patients with nodules greater than 3 cm had more ND-FNAs. Twenty-one of 51 with a ND biopsy underwent a repeat FNAB. Repeat FNAB was ND in 29% of patients. There was malignant disease in 7 of 51 (14%) with a ND-FNAB. Patient age, sex, thyroid function, gland size, multiple nodules, and final pathology were not related to a ND-FNAB (P > .05).
Most patients with a ND-FNAB have benign disease and low-risk patients with a ND-FNAB on repeat FNA warrant a more conservative approach.
甲状腺细针穿刺活检结果为非诊断性（ND-FNAB）会导致不必要的甲状腺切除术。本研究的目的如下：（1）确定ND-FNAB中恶性肿瘤的风险，（2）评估可能识别出有ND-FNAB风险患者的因素。
对总共241例行细针穿刺活检和甲状腺切除术的患者进行与ND-FNAB相关因素的评估。
总共215名女性和26名男性接受了细针穿刺活检和甲状腺切除术。241名患者中有51名（21%）出现ND-FNA。超声引导并未降低非诊断性活检的可能性。结节大于3 cm的患者出现更多的ND-FNA。51名进行非诊断性活检的患者中有21名接受了重复细针穿刺活检。重复细针穿刺活检在29%的患者中结果为非诊断性。51名ND-FNAB患者中有7名（14%）患有恶性疾病。患者的年龄、性别、甲状腺功能、腺体大小、多发结节以及最终病理结果与ND-FNAB无关（P > 0.05）。
大多数ND-FNAB患者患有良性疾病，重复细针穿刺活检结果为ND-FNAB的低风险患者需要采取更保守的方法。
