Hajmanoochehri Fatemeh, Rabiee Elham
Department of Pathology, Qazvin University of Medical Sciences, Qazvin, Iran.
J Cytol. 2015 Oct-Dec;32(4):238-43. doi: 10.4103/0970-9371.171234.
Thyroid fine-needle aspiration cytology (FNAC) is a valuable test used for diagnosing diseases of the thyroid gland.
Using all satisfactory categories of the Bethesda system, this study aimed to determine the accuracy with which FNAC diagnoses thyroid neoplasms. We also discuss the factors that affect diagnosis accuracy.
A comparison was drawn between FNAC results and final histological diagnosis using samples collected over a period of 3 years.
For all patients, age, sex, cytological features, and histological types were determined. All cases of false negative (FN) and false positive (FP) diagnosis were reanalyzed.
The chi-square test and univariate analysis were performed to examine the relationship between different variables.
About 52% of the cases were found malignant, and they were of six different histological types. Papillary carcinoma was the commonest type of malignancy at 76.9%. The rate of malignancy was 63% in males and 49.4% in females. In two of the FN cases, the tumor had a diameter of ≥35 mm. Of the 12 FP cases, nine were in the follicular neoplasm or suspicious for follicular neoplasm Bethesda category. FNAC diagnosis had 95.2% sensitivity, 68.4% specificity, 83.3% positive predictive value, 89.6% negative predictive value, and 85.14% accuracy.
FNAC was found to have a high level of sensitivity and an acceptable degree of specificity in diagnosing different types of thyroid neoplasms. The presence of microfollicular structures or crowded cellular clusters is a challenge to diagnosis, particularly in low-quality specimens.
甲状腺细针穿刺细胞学检查（FNAC）是用于诊断甲状腺疾病的一项重要检查。
本研究使用贝塞斯达系统的所有满意类别，旨在确定FNAC诊断甲状腺肿瘤的准确性。我们还讨论了影响诊断准确性的因素。
对3年期间收集的样本的FNAC结果与最终组织学诊断进行比较。
确定所有患者的年龄、性别、细胞学特征和组织学类型。对所有假阴性（FN）和假阳性（FP）诊断病例进行重新分析。
采用卡方检验和单因素分析来检验不同变量之间的关系。
约52%的病例被发现为恶性，且有六种不同的组织学类型。乳头状癌是最常见的恶性类型，占76.9%。男性恶性率为63%，女性为49.4%。在两例假阴性病例中，肿瘤直径≥35 mm。在12例假阳性病例中，9例属于滤泡性肿瘤或贝塞斯达分类中可疑滤泡性肿瘤。FNAC诊断的敏感性为95.2%，特异性为68.4%，阳性预测值为83.3%，阴性预测值为89.6%，准确性为85.14%。
发现FNAC在诊断不同类型甲状腺肿瘤时具有较高的敏感性和可接受的特异性。微滤泡结构或密集细胞簇的存在对诊断构成挑战，尤其是在低质量标本中。
