Institute of PathologyUniversity Hospital, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandSection of Endocrinology and DiabetologyOspedale Israelitico, Piazza San Bartolomeo all'Isola 21, 00186 Rome, ItalyDepartment of Nuclear Medicine and Thyroid CentreOncology Institute of Southern Switzerland, Viale Officina 3, 6500 Bellinzona, SwitzerlandDivision of Anatomic Pathology and HistologyDepartment of Laboratory Medicine, 'Agostino Gemelli' School of Medicine and Hospital, Catholic University, Largo Francesco Vito 1, 00168 Rome, Italy Institute of PathologyUniversity Hospital, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandSection of Endocrinology and DiabetologyOspedale Israelitico, Piazza San Bartolomeo all'Isola 21, 00186 Rome, ItalyDepartment of Nuclear Medicine and Thyroid CentreOncology Institute of Southern Switzerland, Viale Officina 3, 6500 Bellinzona, SwitzerlandDivision of Anatomic Pathology and HistologyDepartment of Laboratory Medicine, 'Agostino Gemelli' School of Medicine and Hospital, Catholic University, Largo Francesco Vito 1, 00168 Rome, Italy.
Institute of PathologyUniversity Hospital, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandSection of Endocrinology and DiabetologyOspedale Israelitico, Piazza San Bartolomeo all'Isola 21, 00186 Rome, ItalyDepartment of Nuclear Medicine and Thyroid CentreOncology Institute of Southern Switzerland, Viale Officina 3, 6500 Bellinzona, SwitzerlandDivision of Anatomic Pathology and HistologyDepartment of Laboratory Medicine, 'Agostino Gemelli' School of Medicine and Hospital, Catholic University, Largo Francesco Vito 1, 00168 Rome, Italy.
Eur J Endocrinol. 2016 Feb;174(2):R53-63. doi: 10.1530/EJE-15-0817. Epub 2015 Oct 8.
Thyroid fine-needle aspiration (FNA) cytology is a fast growing field. One of the most developing areas is represented by molecular tests applied to cytological material. Patients that could benefit the most from these tests are those that have been diagnosed as 'indeterminate' on FNA. They could be better stratified in terms of malignancy risk and thus oriented with more confidence to the appropriate management. Taking in to consideration the need to improve and keep high the yield of thyroid FNA, professionals from various fields (i.e. molecular biologists, endocrinologists, nuclear medicine physicians and radiologists) are refining and fine-tuning their diagnostic instruments. In particular, all these developments aim at increasing the negative predictive value of FNA to improve the selection of patients for diagnostic surgery. These advances involve terminology, the application of next-generation sequencing to thyroid FNA, the use of immunocyto- and histo-chemistry, the development of new sampling techniques and the increasing use of nuclear medicine as well as molecular imaging in the management of patients with a thyroid nodule. Herein, we review the recent advances in thyroid FNA cytology that could be of interest to the 'thyroid-care' community, with particular focus on the indeterminate diagnostic category.
甲状腺细针抽吸细胞学（FNA）是一个快速发展的领域。其中发展最快的领域之一是应用于细胞学标本的分子检测。最能从这些检测中受益的患者是那些在 FNA 中被诊断为“不确定”的患者。这些患者可以根据恶性风险进行更好的分层，从而更有信心地进行适当的管理。考虑到提高甲状腺 FNA 产量并保持高产量的需要，来自不同领域的专业人员（即分子生物学家、内分泌学家、核医学医师和放射科医师）正在改进和微调他们的诊断工具。特别是，所有这些进展旨在提高 FNA 的阴性预测值，以改善对诊断性手术患者的选择。这些进展涉及术语、下一代测序在甲状腺 FNA 中的应用、免疫细胞化学和组织化学的应用、新采样技术的发展以及核医学以及分子成像在甲状腺结节患者管理中的应用越来越多。在此，我们回顾了甲状腺 FNA 细胞学的最新进展，这些进展可能对“甲状腺护理”社区感兴趣，特别是对不确定的诊断类别。
