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超声引导下细针穿刺活检在甲状腺恶性结节中的诊断价值:对微小结节的应用

Diagnostic value of ultrasound-guided fine needle aspiration biopsy in malignant thyroid nodules: utility for micronodules.

作者信息

Unal Betul, Sezer Cem

机构信息

Pathology, Medical School, Akdeniz University, Antalya, Turkey E-mail :

出版信息

Asian Pac J Cancer Prev. 2014;15(20):8613-6. doi: 10.7314/apjcp.2014.15.20.8613.

Abstract

BACKGROUND

The diagnostic approach to thyroid nodules involves ultrasound-guided fine needle aspiration biopsy (US-FNAB).We especially aimed to evaluate the contribution and the place of US-FNAB in preoperative evaluation of the malignant cases and draw attention to discordant cases diagnosed with papillary thyroid microcarcinoma (PTMC).

MATERIALS AND METHODS

A total of 276 cases were retrospectively reviewed who were subsequently diagnosed with a malignancy and who underwent US-FNAB.

RESULTS

Some 45 were found to have previously undergone the US-FNAB procedure. Of the patients in whom the surgical specimen was diagnosed with a malignancy, 21 (46.7%) were diagnosed as malignant or suspicious for malignancy, and 24 (53.3%) were concluded as benign or insufficient for diagnosis. Patients with the diagnosis of PTMC outnumbering the others was a striking finding (11 cases, 24%).

CONCLUSIONS

We suggest performing repeat aspiration biopsy considering sampling errors in cases where inconsistency exists between clinical findings and cytological results in thyroid nodules smaller than 10 mm in diameter and with suspicious findings on ultrasonography.

摘要

背景

甲状腺结节的诊断方法包括超声引导下细针穿刺活检(US-FNAB)。我们特别旨在评估US-FNAB在恶性病例术前评估中的作用和地位,并关注被诊断为甲状腺微小乳头状癌(PTMC)的不一致病例。

材料与方法

回顾性分析了276例随后被诊断为恶性肿瘤且接受了US-FNAB的病例。

结果

发现约45例之前接受过US-FNAB检查。在手术标本被诊断为恶性肿瘤的患者中,21例(46.7%)被诊断为恶性或疑似恶性,24例(53.3%)被判定为良性或诊断不足。诊断为PTMC的患者数量超过其他患者是一个显著发现(11例,24%)。

结论

我们建议,对于直径小于10mm且超声检查有可疑表现的甲状腺结节,若临床发现与细胞学结果不一致,考虑到采样误差,应进行重复穿刺活检。

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