Zhang Yong-xia, Zhang Bin, Zhang Zhi-hui, Guo Hui-qin, Wang Yong, Xu Zhen-gang, Tang Ping-zhang
Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 Nov;46(11):892-6.
To investigate the clinical application of fine needle aspiration (FNA) cytology of thyroid nodules.
A retrospective review was performed of 474 consecutive cases of FNA cytology of thyroid nodules from October 2005 to January 2011. Two hundred and eighteen patients underwent ultrasound-guided FNA, and 256 patients experienced palpation-guided FNA. Cytologic diagnoses were classified as unsatisfactory, benign, atypical cellular lesion, follicular neoplasm, suspicious for malignancy, and positive for malignancy. The discrepancies between initial cytologic diagnoses and histologic diagnoses were evaluated in 157 surgical specimens.
According to the cytological categories, the rates for histologically confirmed malignancy in the 157 patients were as follows: 2/7 of unsatisfactory results, 16.7% (9/54) of benign lesion, 3/9 of atypical cellular lesion, 1/3 of follicular neoplasm, 83.3% (35/42) of suspicious for malignancies, and 97.6% (41/42) of positive for malignancies. The sensitivity, specificity and positive predictive value of thyroid FNA for the diagnosis of malignancy were 85.4%, 86.9% and 90.5%, respectively.
FNA can provide an accurate diagnosis of thyroid malignancy preoperatively. The 6 diagnostic categories were beneficial for either clinical follow-up or surgical management of the patients with thyroid nodules.
探讨甲状腺结节细针穿刺（FNA）细胞学检查的临床应用。
回顾性分析2005年10月至2011年1月连续474例甲状腺结节FNA细胞学检查病例。218例患者接受超声引导下FNA，256例患者接受触诊引导下FNA。细胞学诊断分为不满意、良性、非典型细胞病变、滤泡性肿瘤、可疑恶性和恶性阳性。对157例手术标本的初始细胞学诊断与组织学诊断之间的差异进行评估。
根据细胞学分类，157例患者中组织学确诊恶性肿瘤的比例如下：不满意结果中为2/7，良性病变中为16.7%（9/54），非典型细胞病变中为3/9，滤泡性肿瘤中为1/3，可疑恶性中为83.3%（35/42），恶性阳性中为97.6%（41/42）。甲状腺FNA诊断恶性肿瘤的敏感性、特异性和阳性预测值分别为85.4%、86.9%和90.5%。
FNA可在术前对甲状腺恶性肿瘤做出准确诊断。这6种诊断分类有助于甲状腺结节患者的临床随访或手术管理。
