Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Florida, College of Medicine, Jacksonville, FL 32209, USA.
Int J Clin Pract. 2010 Jan;64(1):29-33. doi: 10.1111/j.1742-1241.2008.01942.x.
To determine the incidence of Hashimoto's disease in nodular goitre and to ascertain the degree of the concordance between serological and cytological findings.
We retrospectively reviewed data from 188 patients who underwent a fine needle aspiration biopsy of the thyroid for uninodular or multinodular goitre with a documented serological level of antithyroid peroxidase (TPO) antibodies. AntiTPO antibodies were measured by immunochemiluminescent assay (Quest Diagnostics, Madison, NJ, USA).
The study cohort consisted of 170 female and 18 male patients with a mean (+/- SD) age of 47.8 +/- 14.9 years. AntiTPO antibodies were positive in 74 (39.36%) of the individuals and negative in 114 (60.63%). The cytodiagnoses were as follows: 5 (2.6%) cancerous, 18 (9.5%) suspicious, 12 (6.3%) inadequate, 92 (48.9%) benign and 61 (32.4%) consistent with chronic lymphocytic thyroiditis (CLT). For further analysis, we excluded all inadequate specimens. Based on the final sample of 176 patients, the sensitivity and specificity of antiTPO antibody test to detect CLT in nodular goitre were estimated to be 76.38% and 94.23% respectively. The prevalence of CLT in nodular goitre based on cytological criteria was (35.46%) compared with (31.97%) goitre based on positive antiTPO titres only.
There is a high degree of concordance between serological and cytological findings of CLT in people with nodular goitres. The high prevalence of CLT in nodular goitre justifies the use of antiTPO antibodies as part of the workup in this population.
确定桥本氏病在结节性甲状腺肿中的发病率，并确定血清学和细胞学检查结果之间的一致性程度。
我们回顾性分析了 188 例因单发或多发结节性甲状腺肿接受细针穿刺活检的患者的数据，这些患者的抗甲状腺过氧化物酶（TPO）抗体的血清学水平有记录。抗 TPO 抗体采用免疫化学发光法（美国新泽西州麦迪逊市 Quest Diagnostics）进行测量。
研究队列包括 170 名女性和 18 名男性患者，平均（+/-SD）年龄为 47.8 +/- 14.9 岁。74 例（39.36%）患者的抗 TPO 抗体为阳性，114 例（60.63%）为阴性。细胞学诊断结果如下：5 例（2.6%）为癌，18 例（9.5%）为可疑，12 例（6.3%）为不充分，92 例（48.9%）为良性，61 例（32.4%）为慢性淋巴细胞性甲状腺炎（CLT）。为了进一步分析，我们排除了所有不充分的标本。基于 176 例患者的最终样本，抗 TPO 抗体试验检测结节性甲状腺肿中 CLT 的敏感性和特异性估计分别为 76.38%和 94.23%。基于细胞学标准的 CLT 在结节性甲状腺肿中的患病率为（35.46%），而仅基于抗 TPO 滴度阳性的甲状腺肿患病率为（31.97%）。
在结节性甲状腺肿患者中，血清学和 CLT 的细胞学检查结果具有高度一致性。结节性甲状腺肿中 CLT 的高患病率证明了在该人群中使用抗 TPO 抗体作为检查的一部分是合理的。
