Caplan R H, Strutt P J, Kisken W A, Wester S M
Department of Internal Medicine (Endocrinology), Gundersen Clinic Ltd, La Crosse, WI 54601.
Wis Med J. 1991 Jun;90(6):285-8.
Between April 1982 and December 1988, we performed 611 fine needle aspiration (FNA) biopsies in 502 patients with solitary thyroid nodules. The biopsy results were classified as follows: unsatisfactory, 19%; benign, 53%; suspicious, 23%; and malignant, 5%. Malignant lesions were found at surgery in 24 of 25 patients with malignant cytology and 31 of 68 patients with suspicious cytology. Autonomous nodules, obviating the need for surgery, were detected in 5 of 36 (14%) patients with cytology suspicious for follicular neoplasm. We conclude that FNA biopsy of the thyroid nodule is a safe and accurate diagnostic test. Thyroid scintigraphy remains useful in patients with cytologic results suspicious for follicular neoplasm. A cost-effective strategy for managing thyroid nodules is presented.
1982年4月至1988年12月期间，我们对502例患有甲状腺单发结节的患者进行了611次细针穿刺抽吸（FNA）活检。活检结果分类如下：不满意，19%；良性，53%；可疑，23%；恶性，5%。25例细胞学检查为恶性的患者中有24例在手术中发现恶性病变，68例细胞学检查为可疑的患者中有31例在手术中发现恶性病变。在36例细胞学检查怀疑为滤泡性肿瘤的患者中，有5例（14%）检测到自主性结节，从而无需进行手术。我们得出结论，甲状腺结节的FNA活检是一种安全、准确的诊断方法。甲状腺闪烁扫描对细胞学检查结果怀疑为滤泡性肿瘤的患者仍然有用。本文提出了一种经济有效的甲状腺结节管理策略。
