Basharat Rabia, Bukhari Mulazim Hussain, Saeed Shahzad, Hamid Tahira
Department of Pathology, King Edward Medical University, Lahore 54000, Pakistan.
Patholog Res Int. 2011;2011:754041. doi: 10.4061/2011/754041. Epub 2011 May 4.
Objective. This was a comparative study between FNAC and thyroid scan used to diagnose the solitary thyroid nodule and histopathology was used as gold standard to compare the results of both modalities. We hypothesized that Fine needle aspiration cytology and thyroid scan diagnose solitary thyroid nodule (STN) as accurately as histopathology. Materials and Methods. This study comprised of 50 patients with solitary thyroid nodules (STN) presented to OPD. After clinical examination these patients were referred to Centre for Nuclear Medicine, Mayo Hospital Lahore for thyroid function tests and thyroid scan (TS). These patients underwent FNAC in the department of Pathology and surgery in Mayo Hospital. The cases were operated and evaluated for histopathological changes. Results. On thyroid scan, 40 patients (80%) having cold nodule were labeled as suspicious 10 patients (20%) had hot nodule. On FNAC 23 patients (46%) had benign lesion, 22 patients (44%) had indeterminate lesion and 5 patients (10%) had malignant lesions. On histopathology, 45 patients (90%) were confirmed to have benign lesions and 5 patients (10%), malignant lesions. After comparison of results of thyroid scan and FNAC with histopathology, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of thyroid scan were 80%, 20%, 10%, 90% and 26%, respectively whereas those of FNAC were 80%, 97.7%, 80%, 97.7% and 96%, respectively. Conclusion. Fine needle aspiration was a significantly better predictor of malignancy than thyroid scan and resulted in a smaller proportion of excisions for benign nodules.
目的。这是一项比较细针穿刺抽吸活检术（FNAC）与甲状腺扫描用于诊断孤立性甲状腺结节的研究，以组织病理学作为金标准来比较两种方法的结果。我们假设细针穿刺细胞学检查和甲状腺扫描诊断孤立性甲状腺结节（STN）的准确性与组织病理学相同。材料与方法。本研究纳入了50例到门诊就诊的孤立性甲状腺结节（STN）患者。经过临床检查后，这些患者被转诊至拉合尔梅奥医院核医学中心进行甲状腺功能测试和甲状腺扫描（TS）。这些患者在梅奥医院病理科和外科接受了FNAC。对病例进行手术并评估组织病理学变化。结果。在甲状腺扫描中，40例（80%）冷结节患者被标记为可疑，10例（20%）为热结节。在FNAC中，23例（46%）为良性病变，22例（44%）为不确定病变，5例（10%）为恶性病变。在组织病理学上，45例（90%）被确认为良性病变，5例（10%）为恶性病变。将甲状腺扫描和FNAC的结果与组织病理学进行比较后，甲状腺扫描的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为80%、20%、10%、90%和26%，而FNAC的分别为80%、97.7%、80%、97.7%和96%。结论。细针穿刺抽吸活检术在预测恶性肿瘤方面明显优于甲状腺扫描，并且导致良性结节切除的比例更小。
