Baş Veysel Nijat, Aycan Zehra, Cetinkaya Semra, Uner Ciğdem, Cavuşoğlu Yusuf Hakan, Arda Nilüfer
Clinics of Pediatric Endocrinology, Dr. Sami Ulus Research and Training Hospital of Women's and Children's Health and Diseases, Ankara, Turkey.
J Pediatr Endocrinol Metab. 2012;25(7-8):633-8. doi: 10.1515/jpem-2012-0132.
The aims of this study were to analyze the role of fine-needle aspiration biopsy (FNAB) in the management of pediatric thyroid nodules and to analyze the malignancy risk of thyroid nodules by studying the association between autoimmune thyroiditis and thyroid cancer.
We conducted a retrospective study on 111 patients with thyroid nodules diagnosed in childhood or adolescence. FNAB was performed in 46 participants with thyroid nodules after ultrasonography (US). Cytology diagnoses were categorized as insufficient, benign, suspicious, and malignant. Clinical and surgical follow-up data were obtained from medical records. The clinical correlation and accuracy of FNABs were evaluated.
The family history was positive in four patients. Forty-six patients had positive antithyroid antibodies and an inhomogeneous hypoechogenic US pattern. One patient had previous neck irradiation history. Eighty-six patients (%77.5) were euthyroid. All patients underwent US examination. The FNAB results of the 46 patients were 29 (63%) benign cases, 7 (15%) insufficient, and 10 (22%) suspicious patients. Malignancy was not reported at all. A repetition of FNAB in two benign cases, which were diagnosed with papillary carcinoma during followup, reported these cases as suspicious. Ten patients with suspicious FNAB results underwent surgery because of increases in the size of the nodules; two patients were diagnosed with papillary carcinoma. In this study, the prevalence of malignancy was 4.5% in patients with thyroid nodules.
In this study, the importance of FNAB in the diagnosis and follow-up of thyroid nodules in childhood has been observed, and risk factors, such as history of familial thyroid carcinoma, radiotherapy to the neck at younger ages, suspicious cytological findings, and increased nodular sizes during follow-up in cases with Hashimoto thyroiditis have been correlated with increased thyroid carcinoma malignancy risk.
本研究旨在分析细针穿刺活检（FNAB）在儿童甲状腺结节管理中的作用，并通过研究自身免疫性甲状腺炎与甲状腺癌之间的关联来分析甲状腺结节的恶性风险。
我们对111例在儿童期或青春期被诊断为甲状腺结节的患者进行了回顾性研究。46例甲状腺结节患者在超声检查（US）后进行了FNAB。细胞学诊断分为不足、良性、可疑和恶性。从病历中获取临床和手术随访数据。评估FNAB的临床相关性和准确性。
4例患者家族史呈阳性。46例患者抗甲状腺抗体阳性且超声表现为不均匀低回声模式。1例患者有既往颈部放疗史。86例患者（77.5%）甲状腺功能正常。所有患者均接受了超声检查。46例患者的FNAB结果为29例（63%）良性病例，7例（15%）不足，10例（22%）可疑患者。无一例报告为恶性。2例良性病例重复进行FNAB，随访期间诊断为乳头状癌，这2例最初报告为可疑。10例FNAB结果可疑的患者因结节增大接受了手术；2例被诊断为乳头状癌。在本研究中，甲状腺结节患者的恶性患病率为4.5%。
在本研究中，已观察到FNAB在儿童甲状腺结节诊断和随访中的重要性，并且家族性甲状腺癌病史、年轻时颈部放疗、可疑细胞学结果以及桥本甲状腺炎患者随访期间结节增大等危险因素与甲状腺癌恶性风险增加相关。
