Department of Nuclear Medicine, Kyungpook National University Hospital, Dongduk-ro 200, Jung-gu, Daegu 700-721, Republic of Korea.
Radiology. 2013 Mar;266(3):956-63. doi: 10.1148/radiol.12112710. Epub 2012 Dec 6.
To investigate the usefulness of the combined categorical reporting system of ultrasonography (US) and cytology results for thyroid nodules to suggest indications of repeat US-guided fine needle aspiration cytology (FNAC).
Institutional review board approval was obtained, and the requirement for informed consent was waived for this retrospective study. From June 2001 to December 2009, 1084 patients (978 women, 106 men) who underwent repeat US-guided FNAC of thyroid nodules were included. FNAC results were reported by using the Bethesda system for reporting thyroid cytopathologic findings and five thyroid US categories (category US 1, benign; US 2, probably benign; US 3, indeterminate; US 4, probably malignant; US 5, malignant). The relative risk ratios were evaluated in each separate FNAC and combined initial category by means of Cox proportional risk model.
Eighty-one of 1084 (7.5%) patients had malignancy over a mean follow-up time of 20.8 months (range, 3-98 months). Initial FNAC category of atypia of undetermined significance (relative risk ratio, 9.677) and US categories of US 3 (28.76), US 4 (142.0), and US 5 (411.6) had high relative risk ratios for malignancy (P < .05). Combined categories of benign cytology findings with US 3-5, nondiagnostic cytology findings with US 3-5, and atypia of undermined significance with any US categorization had high relative risk ratios of 104.80 (95% confidence interval: 53.328, 205.966).
The combination of the categorical reporting systems between cytology and US results could be useful to suggest indications of repeat US-guided FNAC.
探讨甲状腺结节超声（US）和细胞学结果联合分类报告系统提示再次 US 引导下细针抽吸细胞学（FNAC）适应证的价值。
本研究回顾性分析，获得机构审查委员会批准，且免除患者知情同意。2001 年 6 月至 2009 年 12 月，共纳入 1084 例行再次 US 引导下 FNAC 的甲状腺结节患者（978 例女性，106 例男性）。FNAC 结果采用美国 Bethesda 系统报告甲状腺细胞病理学发现，以及 5 个甲状腺 US 类别（类别 US 1，良性；US 2，可能良性；US 3，不确定；US 4，可能恶性；US 5，恶性）报告。采用 Cox 比例风险模型，在单独的 FNAC 和初始联合类别中评估相对风险比。
在平均 20.8 个月（3-98 个月）的随访中，81 例（7.5%）患者发生恶性肿瘤。不典型意义不明确的细胞学（相对风险比，9.677）和 US 类别 3（28.76）、4（142.0）和 5（411.6）的初始 FNAC 类别恶性肿瘤的相对风险比高（P <.05）。良性细胞学结果伴 US 3-5、不明确的细胞学结果伴 US 3-5、不典型意义不明确伴任何 US 分类的联合类别，其相对风险比为 104.80（95%置信区间：53.328，205.966）。
细胞学和 US 结果分类报告系统的联合可有助于提示再次 US 引导下 FNAC 的适应证。
