Department of Reproduction and Ageing, University of Pisa, Pisa, Italy.
Histopathology. 2011 Nov;59(5):892-6. doi: 10.1111/j.1365-2559.2011.04014.x.
To assess whether the large needle aspiration biopsy (LNAB) histological distinction between pure microfollicular nodules and mixed micro-macrofollicular nodules can assist preoperative selection of a Hürthle cell nodule (HCN) discovered by fine needle aspiration cytology (FNAC).
In 24 HCN identified by preoperative FNAC, preoperative LNAB histology was compared with postoperative pathology. FNAC demonstrated seven benign HCN (negative), eight HCN with atypia (positive); seven suspected cancers with HC (positive); and two cancers with Hürthle cells (positive). LNAB showed mixed micro-macrofollicular hyperplastic features in 12 nodules (negative) and a microfollicular structure in 12 nodules (positive), two of which included findings of papillary cancer. Postoperative findings were benign (negative) in 16 patients and malignant (positive) in eight patients. The sensitivity and specificity for FNAC were 87.5% [seven of eight, 95% confidence interval (CI): 47.3-99.7%) and 37.5% (six of 16, 95% CI: 15.2-64.6%], respectively, and for LNAB were 87.5% (seven of eight, 95% CI: 47.3-99.7%) and 68.8% (11 of 16, 95% CI: 41.3-89.0%), respectively. FNAC results were significantly different from postoperative results (McNemar's test, exact two-sided P=0.012), while LNAB results were not (McNemar's test, exact two-sided P=0.219).
These data suggest that LNAB histology is more accurate than FNAC cytology for the preoperative selection of HCN.
评估大针吸活检（LNAB）在纯微滤泡性结节和混合微-巨滤泡性结节之间的组织学区别是否有助于术前选择细针抽吸细胞学（FNAC）发现的 Hurthle 细胞结节（HCN）。
在术前 FNAC 确定的 24 个 HCN 中，将术前 LNAB 组织学与术后病理进行比较。FNAC 显示 7 个良性 HCN（阴性），8 个 HCN 伴不典型（阳性）；7 个疑似伴有 HC 的癌症（阳性）；2 个伴有 Hurthle 细胞的癌症（阳性）。LNAB 显示 12 个结节呈混合微-巨滤泡性增生特征（阴性），12 个结节呈微滤泡结构（阳性），其中 2 个结节包括乳头状癌的发现。术后发现 16 例患者为良性（阴性），8 例患者为恶性（阳性）。FNAC 的敏感性和特异性分别为 87.5%[8 例中的 7 例，95%置信区间（CI）：47.3-99.7%]和 37.5%（16 例中的 6 例，95%CI：15.2-64.6%），LNAB 的敏感性和特异性分别为 87.5%（8 例中的 7 例，95%CI：47.3-99.7%）和 68.8%（16 例中的 11 例，95%CI：41.3-89.0%）。FNAC 结果与术后结果差异有统计学意义（McNemar 检验，双侧精确 P=0.012），而 LNAB 结果无差异（McNemar 检验，双侧精确 P=0.219）。
这些数据表明，LNAB 组织学比 FNAC 细胞学更准确，可用于术前选择 HCN。
