Das Dilip K, Sheikh Mehraj, Mallik Mrinmay K, Sharma Prem N, Mannan Abul A S R, Sheikh Zafar A, Haji Bahia I, George Shirly S, Madda John P, Hussein Sundus, Francis Issam M
Department of Pathology, Center for Research, Faculty of Medicine, Kuwait University, Safat, Kuwait.
Indian J Pathol Microbiol. 2010 Oct-Dec;53(4):686-91. doi: 10.4103/0377-4929.72032.
During routine fine needle aspiration cytodiagnosis of papillary thyroid carcinoma (PTC), a number of cases are diagnosed as suspicious; or it is suggested that PTC or a neoplasm be ruled out by histopathology. Since these diagnostic labels are likely to put the clinicians in a difficult situation while planning the management, this study aims to find out how much the surgeon should read from these reports.
The patients were divided into two groups. Group A included 38 cases diagnosed as PTC or suspicious of PTC. Group B included 40 cases in which it was suggested that PTC/a neoplasm to be ruled out and non-neoplastic lesions with one or more cytologic features of PTC. The two groups were compared with clinical, imaging and cytomorphologic features.
A significant difference was observed with respect to age between Group A and Group B (P<0.001). The frequency of the following five cytologic features was significantly higher in Group A: papillary formation (P<0.001), psammoma bodies (P=0.054), fine nuclear chromatin (P=0.010), frequent nuclear grooves (P<0.001) and intra-nuclear cytoplasmic inclusion (P<0.001). Three or more of the five cytologic features were also reported in significantly higher number of Group A cases (P<0.001). Majority (81.8%) of the cases with subsequent histology in Group A were confirmed as PTC as opposed to 7.7% in Group B (P<0.001).
Thus, cases with definitive cytodiagnosis of PTC and suggestive of PTC (Group A) should be taken much more seriously by the surgeons as compared to Group B cases.
在甲状腺乳头状癌（PTC）的常规细针穿刺细胞诊断过程中，有一些病例被诊断为可疑；或者建议通过组织病理学排除PTC或肿瘤。由于这些诊断标签在制定治疗方案时可能会使临床医生陷入困境，本研究旨在找出外科医生应从这些报告中获取多少信息。
将患者分为两组。A组包括38例被诊断为PTC或疑似PTC的病例。B组包括40例建议排除PTC/肿瘤以及具有一个或多个PTC细胞学特征的非肿瘤性病变的病例。对两组的临床、影像学和细胞形态学特征进行比较。
A组和B组在年龄方面存在显著差异（P<0.001）。以下五个细胞学特征在A组中的出现频率显著更高：乳头形成（P<0.001）、砂粒体（P=0.054）、细核染色质（P=0.010）、频繁的核沟（P<0.001）和核内假包涵体（P<0.001）。A组中也有显著更多的病例报告具有五个细胞学特征中的三个或更多（P<0.001）。A组中后续组织学检查的大多数病例（81.8%）被确认为PTC，而B组为7.7%（P<0.001）。
因此，与B组病例相比，外科医生应更重视具有明确PTC细胞诊断和提示PTC的病例（A组）。
