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甲状腺结节细针穿刺细胞学检查的诊断效能及重要性

Diagnostic efficacy and importance of fine-needle aspiration cytology of thyroid nodules.

作者信息

Muratli Asli, Erdogan Nilsen, Sevim Sezgin, Unal Isik, Akyuz Serap

机构信息

Department of Pathology, Onsekiz Mart University, School of Medicine, Canakkale, Turkey.

Department of Pathology, Taksim Education and Research Hospital, Istanbul, Turkey.

出版信息

J Cytol. 2014 Apr;31(2):73-8. doi: 10.4103/0970-9371.138666.

Abstract

BACKGROUND

Fine-needle aspiration cytology (FNAC) in the diagnosis of thyroid nodules is an easy and cost-effective method. The increase in malignancy rates of the excised nodules due to the high sensitivity and specificity rates of the FNAC is remarkable.

AIM

The aim of this study was to assess the effectiveness of FNAC in the evaluation of thyroid nodules by comparing the results with histopathologic evaluation and comparing the consistency of the results with the literature.

MATERIALS AND METHODS

In this study, 1607 FNACs of 1333 patients which were classified according to the Bethesda system and 126 histopathological evaluations obtained from this group were evaluated. The mean age of the patients was 51.24 (range: 17-89, 17% male and 83% female). The sensitivity, specificity, positive and negative predictive values, and accuracy rates were evaluated.

RESULTS

The sensitivity was 87.1% and specificity was 64.6%. The positive and negative predictive value and accuracy rates were 76.1%, 79.5%, and 77.3%, respectively.

CONCLUSIONS

In our study, the evaluation of thyroid FNAC samples with Bethesda system highly correlated with the results of histopathological diagnosis. However, combination of additional and advanced diagnostic methods such as immunocytochemical studies and molecular pathology techniques enhance the prognostic value of FNAC in patients with atypia of undetermined significance or follicular lesion of undetermined significance, lesions suspicious for malignancy, and suspected follicular neoplasm.

摘要

背景

细针穿刺细胞学检查(FNAC)是诊断甲状腺结节的一种简便且经济有效的方法。由于FNAC的高敏感性和特异性,切除结节的恶性率显著增加。

目的

本研究旨在通过将结果与组织病理学评估进行比较,并将结果的一致性与文献进行比较,评估FNAC在评估甲状腺结节中的有效性。

材料与方法

本研究评估了1333例患者的1607次FNAC,这些FNAC根据贝塞斯达系统进行分类,并对该组患者进行了126次组织病理学评估。患者的平均年龄为51.24岁(范围:17 - 89岁,男性占17%,女性占83%)。评估了敏感性、特异性、阳性和阴性预测值以及准确率。

结果

敏感性为87.1%,特异性为64.6%。阳性和阴性预测值及准确率分别为76.1%、79.5%和77.3%。

结论

在我们的研究中,用贝塞斯达系统评估甲状腺FNAC样本与组织病理学诊断结果高度相关。然而,免疫细胞化学研究和分子病理学技术等额外的先进诊断方法相结合,可提高FNAC对意义未明的非典型性病变或意义未明的滤泡性病变、可疑恶性病变及可疑滤泡性肿瘤患者的预后价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09b0/4159900/703e8e19dd85/JCytol-31-73-g003.jpg

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