超声检查有回声点的甲状腺结节中额外进行冯·科萨染色的价值

Value of additional von Kossa staining in thyroid nodules with echogenic spots on ultrasound.

作者信息

Chae In Hye, Kwon Hyeong Ju, Kim Eun-Kyung, Moon Hee Jung, Yoon Jung Hyun, Lee Hye Sun, Kwak Jin Young

机构信息

Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea.

Department of Pathology, Yonsei University, College of Medicine, Seoul, South Korea; Department of Pathology, Yonsei University, Wonju College of Medicine, Seoul, South Korea.

出版信息

Pathol Res Pract. 2016 May;212(5):415-20. doi: 10.1016/j.prp.2016.02.014. Epub 2016 Feb 10.

DOI:10.1016/j.prp.2016.02.014

PMID:26916952

Abstract

PURPOSE

To evaluate the clinical value of additional von Kossa staining on cytology in thyroid nodules with echogenic spots on ultrasound (US).

MATERIALS AND METHODS

342 thyroid nodules were analyzed for cytology and von Kossa staining was performed to detect microcalcifications. We compared diagnostic performances and accuracies of FNA and FNA with von Kossa staining to detect malignancy. We evaluated associations of aggressive pathologic features and von Kossa positivity in the surgically confirmed papillary thyroid carcinoma (PTC) group.

RESULTS

Two hundred and thirty two (67.8%) nodules were malignant and 110 (32.2%) were benign on cytopathology. Compared to cytology alone, additional von Kossa staining slightly improved sensitivity from 89.7% to 90.9% (P=0.081). In 207 cases of surgically confirmed PTC, von Kossa positivity was an independent predictor of central lymph node metastasis in PTCs by multivariate analysis (odds ratio, 2.218; P=0.021).

CONCLUSIONS

Adding von Kossa staining to cytology improved the sensitivity of thyroid nodules with echogenic spots on US. Positive von Kossa stains in PTCs may also be useful in predicting central lymph node metastasis.

摘要

目的

评估对超声（US）检查有回声斑点的甲状腺结节进行细胞学检查时额外进行冯·科萨染色的临床价值。

材料与方法

对342个甲状腺结节进行细胞学分析，并进行冯·科萨染色以检测微钙化。我们比较了细针穿刺抽吸活检（FNA）以及FNA联合冯·科萨染色检测恶性肿瘤的诊断性能和准确性。我们评估了手术确诊的甲状腺乳头状癌（PTC）组中侵袭性病理特征与冯·科萨染色阳性之间的关联。

结果

在细胞病理学检查中，232个（67.8%）结节为恶性，110个（32.2%）为良性。与单纯细胞学检查相比，额外进行冯·科萨染色使敏感性从89.7%略微提高到90.9%（P = 0.081）。在207例手术确诊的PTC病例中，通过多因素分析，冯·科萨染色阳性是PTC中央淋巴结转移的独立预测因素（比值比，2.218；P = 0.021）。