甲状腺结节处理中细针穿刺细胞学检查、放射性同位素检查及超声扫描的比较
Comparison of fine needle aspiration cytology, radioisotopic and ultrasound scanning in the management of thyroid nodules.
作者信息
Jones A J, Aitman T J, Edmonds C J, Burke M, Hudson E, Tellez M
机构信息
Endocrine Research Group, Northwick Park Hospital, Harrow, Middlesex, UK.
出版信息
Postgrad Med J. 1990 Nov;66(781):914-7. doi: 10.1136/pgmj.66.781.914.
In 175 patients presenting with thyroid nodules, the diagnostic value in management of fine needle aspiration and cytology (FNAC), pertechnetate (99mTc) scanning and ultrasound imaging was examined. In 82 patients, the diagnosis was confirmed at operation; in the remaining 93, there was a follow-up period of at least 2 years. Thyroid cancer was found in 13 patients. For FNAC the sensitivity, specificity and positive predictive value for thyroid cancer were 92%, 85% and 41% respectively compared with 82%, 34% and 11% for 99mTc pertechnetate scanning, 75%, 61%, 19% for ultrasound and 73%, 58% and 19% for combined pertechnetate and ultrasound scanning. In 14% of patients, the aspirates were inadequate for cytology at the first examination. FNAC is therefore the preferable initial investigation and usually gives results adequate for a decision on surgical or medical management. With medical management and follow-up, ultrasound is of value in defining the nodule and the appearance of the rest of the gland.
对175例甲状腺结节患者进行了细针穿刺抽吸及细胞学检查（FNAC）、高锝酸盐（99mTc）扫描和超声成像检查在管理中的诊断价值研究。82例患者通过手术确诊；其余93例进行了至少2年的随访。发现13例甲状腺癌患者。FNAC对甲状腺癌的敏感性、特异性和阳性预测值分别为92%、85%和41%，而99mTc高锝酸盐扫描分别为82%、34%和11%，超声分别为75%、61%、19%，高锝酸盐和超声联合扫描分别为73%、58%和19%。14%的患者首次检查时穿刺物不足以进行细胞学检查。因此，FNAC是首选的初始检查，通常能给出足以决定手术或内科治疗的结果。在内科治疗和随访过程中，超声对于明确结节及腺体其他部分的外观有价值。
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