Second Medical Clinic, Medical School, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece.
Thyroid. 2010 Mar;20(3):265-71. doi: 10.1089/thy.2009.0157.
Thyroid fine-needle biopsy (FNB) is a simple, reliable, inexpensive, and generally safe diagnostic procedure in the management of thyroid nodules. Local pain and minor hematomas are the most common clinical complications, and hemorrhage and fibrosis the most common histological alterations after thyroid FNB. FNB can also trigger biochemical alterations in serum, since it may destroy thyroid follicles. In this review we summarized the biochemical alterations in serum that occur after diagnostic thyroid FNB, aiming to review information that would be potentially useful in interpreting thyroid tests in patients who recently had a thyroid FNB.
Computerized advanced search for primary evidence was performed in the PubMed (Public/Publisher MEDLINE) electronic database not limited by publication time and English language. An increase in serum thyroglobulin (Tg) ranging from 35% to 341% occurs in 33-88% of patients subjected to FNB. Serum Tg concentrations typically return to baseline about 2-3 weeks after FNB. The abrupt release of Tg after FNB may induce the production of autoantibodies to Tg and thyroid hormones in a minority of patients. There is little information on the effect of FNB on autoantibodies to thyroid peroxidase. No changes seem to occur in thyroid-stimulating hormone, total thyroxine, free thyroxine, free triiodothyronine (T3), or reverse T3, while controversy exists for T3.
The degree of increase in serum Tg after FNB is highly variable and not a predictor of whether the biopsied nodule is benign or malignant. The increase or development of Tg autoantibodies that occurs in some patients does not appear to be of clinical significance. Development of autoantibodies to thyroid hormones may be more likely in patients whose biopsied nodule is benign than malignant, but further studies are required to confirm this. If changes in serum thyroid-stimulating hormone or thyroid hormones are noted in a patient with a history of a recent fine-needle aspiration, they should be investigated since they are not likely to be related to the biopsy.
甲状腺细针穿刺活检（FNB）是一种简单、可靠、经济且通常安全的诊断甲状腺结节的方法。局部疼痛和小血肿是最常见的临床并发症，出血和纤维化是甲状腺 FNB 后最常见的组织学改变。FNB 还可以破坏甲状腺滤泡，从而导致血清中的生化改变。在本文中，我们总结了诊断性甲状腺 FNB 后血清中的生化改变，旨在回顾可能有助于解释最近接受甲状腺 FNB 的患者甲状腺检测结果的信息。
在不限制发表时间和语言的情况下，在 PubMed（公共/出版商 MEDLINE）电子数据库中进行了原发性证据的计算机高级检索。33%-88%的 FNB 患者的血清甲状腺球蛋白（Tg）升高 35%-341%。FNB 后约 2-3 周，血清 Tg 浓度通常恢复基线。FNB 后 Tg 的突然释放可能会导致少数患者产生针对 Tg 和甲状腺激素的自身抗体。关于 FNB 对甲状腺过氧化物酶自身抗体的影响，信息很少。甲状腺刺激激素、总甲状腺素、游离甲状腺素、游离三碘甲状腺原氨酸（T3）或反 T3 似乎没有变化，而 T3 则存在争议。
FNB 后血清 Tg 升高的程度高度可变，不能预测活检结节是良性还是恶性。一些患者发生的 Tg 自身抗体的增加或出现似乎没有临床意义。与恶性结节相比，良性结节患者更有可能产生针对甲状腺激素的自身抗体，但需要进一步研究来证实这一点。如果近期细针抽吸的患者出现血清甲状腺刺激激素或甲状腺激素的变化，应进行调查，因为它们不太可能与活检有关。
