Kim Soo-Yeon, Kim Eun-Kyung, Moon Hee Jung, Yoon Jung Hyun, Kwon Hyeong Ju, Song Mi Kyung, Kwak Jin Young
Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Endocrine. 2016 Jul;53(1):157-65. doi: 10.1007/s12020-015-0835-z. Epub 2015 Dec 29.
The purpose of the study was to compare the diagnostic utility of the combined conventional smear (CS) and liquid-based preparation (LBP) compared to CS with respect to the non-diagnostic rate, the atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS) rate, and the diagnostic performances for malignancy. This retrospective study was approved by the Institutional Review Board, and the need to obtain informed consent was waived. In our institution, thyroid FNAs were processed with CS before October 2012, and LBP has been used in combination with CS after October 2012. On-site evaluation for the adequacy of CS was not performed. This study included nodules 5 mm or larger with FNAs performed by faculties: 811 nodules in 773 patients for CS, and 926 nodules in 894 patients for combined CS and LBP. Nodules with surgery or either benign or malignancy cytology on initial or repeat FNA were regarded to have the reference standards needed to calculate diagnostic performances. The proportion of Bethesda categories and diagnostic performances were compared between the two groups with z test. The non-diagnostic rate, the AUS or FLUS rate, and the diagnostic performances for malignancy were similar (All P > 0.05). The follicular neoplasm (FN) or suspicious for FN rate decreased from 1.2 to 0.3 % (P = 0.034). The benign rate increased from 51.4 to 57.0 % (P = 0.019). Combined CS and LBP decreased FN or suspicious for FN diagnoses, and increased benign diagnoses compared to CS with comparable non-diagnostic rates and AUS or FLUS rates, and comparable diagnostic performances.
本研究的目的是比较联合传统涂片（CS）和液基制片（LBP）与单独使用CS相比，在非诊断率、意义不明确的非典型病变（AUS）或意义不明确的滤泡性病变（FLUS）率以及恶性肿瘤诊断性能方面的诊断效用。这项回顾性研究获得了机构审查委员会的批准，且无需获得知情同意。在我们机构，2012年10月之前甲状腺细针穿刺抽吸活检（FNA）采用CS处理，2012年10月之后LBP与CS联合使用。未对CS的充分性进行现场评估。本研究纳入了由教员进行FNA的5毫米或更大的结节：CS组773例患者中的811个结节，联合CS和LBP组894例患者中的926个结节。在初次或重复FNA时进行了手术或具有良性或恶性细胞学结果的结节被视为具有计算诊断性能所需的参考标准。采用z检验比较两组之间的贝塞斯达分类比例和诊断性能。两组的非诊断率、AUS或FLUS率以及恶性肿瘤诊断性能相似（所有P>0.05）。滤泡性肿瘤（FN）或可疑FN率从1.2%降至0.3%（P=0.034）。良性率从51.4%升至57.0%（P=0.019）。与CS相比，联合CS和LBP减少了FN或可疑FN诊断，增加了良性诊断，且非诊断率、AUS或FLUS率以及诊断性能相当。
