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甲状腺结节细针穿刺细胞学与细针毛细血管细胞学的比较研究

A Comparative Study on Fine Needle Aspiration Cytology versus Fine Needle Capillary Cytology in Thyroid Nodules.

作者信息

Tauro Leo F, Lobo Geover J, Fernandes Hilda, George Celine, Aithala P Sathyamoorthy, Shenoy Divakar, Shetty Prathvi

出版信息

Oman Med J. 2012 Mar;27(2):151-6. doi: 10.5001/omj.2012.31.

Abstract

OBJECTIVES

Fine needle aspiration cytology (FNAC/FNA) is the primary investigation for thyroid nodules. Fine needle capillary cytology (FNCC/FNC) is an alternative technique not commonly used, though it is easy to perform. Both the techniques have their own advantages and disadvantages. This study aims to compare these two cytological techniques for better specimen and cytological diagnosis.

METHODS

This prospective study was conducted on 50 patients attending the FR Muller Medical College Hospital from May 2006 to April 2008. The patients with thyroid nodules (diagnosed by palpation) were subjected to both the cytological techniques; FNA and FNC. The specimen and results were compared and then correlated with the final histopathological findings wherever surgical specimens were available (38 cases).

RESULTS

The mean age of the patients was 39.16 with a female predominance. The majority of cases were diagnosed to have nodular goiters. The FNC technique yielded 88% diagnostic superiority and adequate specimens compared to 94% by FNA. Sensitivity was 50% for FNC and 100% for FNA while specificity was 100% for both techniques; accuracy score was 97.4% for FNC and 100% for FNA in predicting malignancy. While sensitivity was 75% for FNC and 100% for FNA; specificity was 100% for both techniques, and accuracy score was 97.4% for FNC and 100% for FNA in the prediction of neoplasia.

CONCLUSION

The results indicated that there was no significant difference between the two techniques; if done in tandem can give better and accurate cytological diagnosis. In highly cellular lesions, in which abundant material was obtained, FNC was more likely to be diagnostically superior, but FNA can diagnose most of the lesions. In less cellular lesions, FNA is more likely to be diagnostically superior to FNC.

摘要

目的

细针穿刺细胞学检查(FNAC/FNA)是甲状腺结节的主要检查方法。细针毛细管细胞学检查(FNCC/FNC)是一种较少使用的替代技术,尽管操作简便。这两种技术都有各自的优缺点。本研究旨在比较这两种细胞学技术,以获得更好的标本和细胞学诊断。

方法

本前瞻性研究于2006年5月至2008年4月对50例就诊于FR·穆勒医学院医院的患者进行。对甲状腺结节患者(通过触诊诊断)同时采用两种细胞学技术,即FNA和FNC。比较标本和结果,然后在有手术标本的情况下(38例)与最终组织病理学结果进行相关性分析。

结果

患者的平均年龄为39.16岁,女性占多数。大多数病例被诊断为结节性甲状腺肿。与FNA的94%相比,FNC技术的诊断优势率为88%,且能获得足够的标本。FNC的敏感性为50%,FNA为100%;两种技术的特异性均为100%;在预测恶性肿瘤方面,FNC的准确率为97.4%,FNA为100%。在预测肿瘤形成方面,FNC的敏感性为75%,FNA为100%;两种技术的特异性均为100%,FNC的准确率为97.4%,FNA为100%。

结论

结果表明,两种技术之间无显著差异;如果联合使用,可提供更好、更准确的细胞学诊断。在细胞丰富的病变中,若能获得丰富的材料,FNC更有可能在诊断上具有优势,但FNA能诊断大多数病变。在细胞较少的病变中,FNA在诊断上更有可能优于FNC。

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