Department of Pathology, The Johns Hopkins Hospital, Path 406, 600 N Wolfe St, Baltimore, MD 21287, USA.
Am J Clin Pathol. 2012 Jul;138(1):90-5. doi: 10.1309/AJCP84AXSRABZCTZ.
Recent increases in the number of thyroid fine-needle aspiration (FNAs) biopsies and the popularity of on-site evaluation for adequacy (OSEA) have led many practices, including ours, to rely on cytotechnologists for performing OSEA. We retrospectively analyzed the accuracy of a cytotechnologist against that of a cytopathologist in performing OSEA and making the final diagnosis. Of 2,261 thyroid FNA specimens evaluated over a 33-month period under ultrasound guidance with OSEA, the cytotechnologist attended 64.7% (1,462/2,261) of the procedures whereas the cytopathologist attended 35.3% (799/2,261). There was no difference in the adequacy downgrade rate for cytotechnologists compared with that for cytopathologists during this study period (4.1% vs 5.0% downgrade rate, P = .33). Regardless of who rendered the OSEA, subadequate specimens had a higher rate of indeterminate diagnosis (25.2%) than those specimens deemed adequate at the time of OSEA (11.9%, P = .00001). These results indicate that the accuracy of cytotechnologists is comparable with that of cytopathologists in conducting OSEA of the thyroid.
近年来，甲状腺细针抽吸活检（FNAs）的数量增加，现场评估充足性（OSEA）的普及，使得包括我们在内的许多医疗机构依赖细胞技术人员来进行 OSEA。我们回顾性地分析了细胞技术员在进行 OSEA 和做出最终诊断方面的准确性，与细胞病理学家进行比较。在超声引导下进行 OSEA 的 33 个月期间，评估了 2261 例甲状腺 FNA 标本，细胞技术员参加了 64.7%（1462/2261）的程序，而细胞病理学家参加了 35.3%（799/2261）。在本研究期间，细胞技术员的充分性降级率与细胞病理学家相比没有差异（4.1%与 5.0%的降级率，P =.33）。无论谁进行了 OSEA，不充分的标本有更高的不确定诊断率（25.2%），而在 OSEA 时被认为充分的标本的不确定诊断率为 11.9%（P =.00001）。这些结果表明，细胞技术人员在进行甲状腺 OSEA 方面的准确性可与细胞病理学家相媲美。
