甲状腺肿患者细针穿刺结果为阴性：我们应该怀疑吗？
Negative Fine-Needle Aspiration in Patients with Goiter: Should We Doubt It?
作者信息
Mekel Michal, Gilshtein Hayim, Al-Kurd Abbas, Bishara Bishara, Krausz Michael M, Freund Herbert R, Kluger Yoram, Eid Ahmed, Mazeh Haggi
机构信息
Department of General Surgery, Rambam Health Care Campus, Haifa, Israel.
Technion - Israel Institute of Technology, Haifa, Israel.
出版信息
World J Surg. 2016 Jan;40(1):124-8. doi: 10.1007/s00268-015-3216-0.
BACKGROUND
Epidemiologic studies demonstrated higher incidence of thyroid cancer in patients with multinodular goiters compared to the general population. The aim of this study was to evaluate the risk of finding significant thyroid cancer in patients undergoing thyroidectomy for presumed benign disease.
METHODS
The records of 273 patients operated for indications other than cancer or indeterminate cytology were reviewed and analyzed.
RESULTS
202 (74%) patients had a preoperative fine-needle aspiration (FNA) performed. FNA was benign in 96% of patients and non-diagnostic in 4%. Malignancy was unexpectedly found in 50 (19%) patients. Papillary carcinoma constituted 94% of cancers and 86% of cancers were incidental microcarcinomas. Only 7 (2.6%) patients of the entire cohort had tumors greater than 1 cm, of those only 3 had a previous benign FNA (false-negative rate 1.5%).
CONCLUSIONS
The rate of significant thyroid cancer found unexpectedly in resected goiters is extremely low. A negative FNA excludes significant cancer with near certainty.
背景
流行病学研究表明，与普通人群相比，多结节性甲状腺肿患者的甲状腺癌发病率更高。本研究的目的是评估因假定为良性疾病而接受甲状腺切除术的患者中发现显著甲状腺癌的风险。
方法
回顾并分析了273例因非癌症或不确定细胞学指征而接受手术的患者的记录。
结果
202例（74%）患者术前进行了细针穿刺抽吸（FNA）。96%的患者FNA结果为良性，4%为非诊断性。意外发现50例（19%）患者患有恶性肿瘤。乳头状癌占癌症的94%，86%的癌症为偶然发现的微小癌。整个队列中只有7例（2.6%）患者的肿瘤大于1厘米，其中只有3例之前FNA结果为良性（假阴性率为1.5%）。
结论
在切除的甲状腺肿中意外发现显著甲状腺癌的比率极低。FNA结果为阴性几乎可以确定排除显著癌症。
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