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传统细胞学与液基细胞学在甲状腺病变诊断中的效能比较:10360例细针穿刺细胞学病例评估

Diagnostic efficacy of conventional as compared to liquid-based cytology in thyroid lesions: evaluation of 10,360 fine needle aspiration cytology cases.

作者信息

Rossi Esther Diana, Raffaelli Marco, Zannoni Gian Franco, Pontecorvi Alfredo, Mulè Antonino, Callà Cinzia, Lombardi Celestino Pio, Fadda Guido

机构信息

Division of Anatomic Pathology, Catholic University of Sacred Heart, Rome, Italy.

出版信息

Acta Cytol. 2009 Nov-Dec;53(6):659-66. doi: 10.1159/000325407.

Abstract

OBJECTIVE

To evaluate the efficacy of thyroid fine needle aspiration cytology (FNAC) processed by liquid-based cytology (LBC) as compared to conventional smears (CS) in 10,360 consecutive cases in 3 reference periods.

STUDY DESIGN

In 1997-1998, 2,394 FNACs had CS; in 2001-2002, 3,463 had both CS and LBC; and in 2004-2005, 4,503 had only LBC. Three arbitrary parameters of efficacy were chosen to compare the two different methods: rate of inadequacy (IR), rate of indeterminacy (INDR) and rate of malignancy (MR). In the same biennia 6,184 thyroidectomy specimens were examined.

RESULTS

IR was, respectively, 8.4% in 1997-1998, 18.4% in 2001-2002 and 13.3% in 2004-2005. MR was respectively 2.2%, 2.5% and 2.2%. INDR was 16.6% in 1997-1998, 23.3% in 2001-2002 and 15.9% in 2004-2005. In each biennium, respectively, 16.9%, 27.6% and 28% of malignant neoplasms were histologically diagnosed.

CONCLUSION

LBC was used as an alternative method in the cytologic diagnosis for the preoperative selection of thyroid neoplasms, decreasing indeterminate diagnoses without MR changes.

摘要

目的

评估在三个参考时间段内,10360例连续病例中,液基细胞学(LBC)处理的甲状腺细针穿刺细胞学检查(FNAC)与传统涂片(CS)相比的效果。

研究设计

1997 - 1998年,2394例FNAC采用CS;2001 - 2002年,3463例同时采用CS和LBC;2004 - 2005年,4503例仅采用LBC。选择三个任意的效果参数来比较两种不同方法:不满意率(IR)、不确定率(INDR)和恶性率(MR)。在同一两年期内,对6184例甲状腺切除标本进行了检查。

结果

1997 - 1998年IR分别为8.4%,2001 - 2002年为18.4%,2004 - 2005年为13.3%。MR分别为2.2%、2.5%和2.2%。1997 - 1998年INDR为16.6%,2001 - 2002年为23.3%,2004 - 2005年为15.9%。在每个两年期内,分别有16.9%、27.6%和28%的恶性肿瘤通过组织学诊断。

结论

LBC被用作甲状腺肿瘤术前选择的细胞学诊断替代方法,在不改变MR的情况下减少了不确定诊断。

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