Kuru Bekir, Gulcelik Nese Ersoz, Gulcelik Mehmet Ali, Dincer Halil
Department of General Surgery, Ondokuz Mayis University School of Medicine, Samsun, Turkey.
Head Neck. 2009 Jul;31(7):856-66. doi: 10.1002/hed.21049.
The objective of this study was to select patients for resection of thyroid malignity among patients with thyroid nodules by integration of predictive indices with fine-needle aspiration cytology (FNAC).
Characteristics of 571 euthyroid patients with thyroid nodules who underwent surgery in our institution were prospectively recorded. Predictive factors for malignancy were identified and categorized as predictive indices that were integrated with FNAC to select patients for surgery.
Eighty-three (14.5%) of the 571 patients had thyroid carcinoma. Size > or =4 cm, age > or =65, cervical lymph nodes, solid structure, hypoechogenicity, microcalcification, and elevated serum thyroglobulin levels were independent predictive factors associated with thyroid malignancy. Sensitivity, specificity, and accuracy of FNAC were 88%, 80%, and 81%, respectively, and were 100% for index 3.
Patients with malignant and suspicious FNAC findings and, among patients with follicular neoplasm and nondiagnostic FNAC findings, those with > or =2 risk factors should undergo surgery.
本研究的目的是通过将预测指标与细针穿刺细胞学检查（FNAC）相结合，在甲状腺结节患者中选择适合进行甲状腺恶性肿瘤切除的患者。
前瞻性记录了在我们机构接受手术的571例甲状腺功能正常的甲状腺结节患者的特征。确定了恶性肿瘤的预测因素，并将其分类为预测指标，与FNAC相结合以选择手术患者。
571例患者中有83例（14.5%）患有甲状腺癌。大小≥4 cm、年龄≥65岁、颈部淋巴结、实性结构、低回声、微钙化和血清甲状腺球蛋白水平升高是与甲状腺恶性肿瘤相关的独立预测因素。FNAC的敏感性、特异性和准确性分别为88%、80%和81% , 指标3的敏感性、特异性和准确性均为100%。
FNAC结果为恶性和可疑的患者，以及在滤泡性肿瘤且FNAC结果无法诊断的患者中，有≥2个危险因素的患者应接受手术。
