Sharma Chetna
Department of Pathology, PSG Institute of Medical Sciences, Coimbatore, Tamil Nadu, India.
J Cytol. 2016 Oct-Dec;33(4):192-198. doi: 10.4103/0970-9371.190455.
The role of fine-needle aspiration cytology (FNAC) in thyroid nodules has been well-studied but there is a paucity of studies solely involving papillary thyroid carcinoma (PTC). The diagnostic criteria for PTC are established but still there is a worrisome possibility of false positive and false-negative results, which can have a serious impact on patient care. This article correlates the cytological and histological diagnosis of PTC with an eventual aim of analyzing the cause of false positive and false negative results in order to prevent misdiagnosis. An increase in the incidence of PTC in the younger population has been noted.
To analyze the epidemiological trends and cytohistological correlation of PTC and evaluate the discordant cases and pitfalls of FNAC.
Seventy-two cases who had undergone both FNAC and histopathological examination (HPE) of the thyroid gland were selected. Age and sex distribution as well as cytohistological correlation were done for all the cases.
Cytohistological correlation was 81.94%. False positives were 5.56% and the false negative rate was 13.2%. Sensitivity was 86.7% and the positive predictive value was 93.6%. The peak age was 31-40 years among females and 41-60 years among males. Seven of our patients were <20 years of age (10%).
FNAC is an indispensible tool for the early diagnosis of PTC. However, certain conditions of the thyroid gland can cause diagnostic dilemma. Awareness of pathologists regarding these pitfalls can prevent misdiagnosis and provide better patient care. Increasing the incidence of PTC with a more striking increase in the younger population makes early diagnosis all the more important owing to better prognosis in this age group.
细针穿刺细胞学检查（FNAC）在甲状腺结节中的作用已得到充分研究，但专门针对甲状腺乳头状癌（PTC）的研究较少。PTC的诊断标准已经确立，但假阳性和假阴性结果的可能性仍然令人担忧，这可能会对患者的治疗产生严重影响。本文将PTC的细胞学和组织学诊断相关联，最终目的是分析假阳性和假阴性结果的原因，以防止误诊。已注意到年轻人群中PTC的发病率有所增加。
分析PTC的流行病学趋势和细胞组织学相关性，并评估FNAC的不一致病例和陷阱。
选择72例接受过甲状腺FNAC和组织病理学检查（HPE）的病例。对所有病例进行年龄和性别分布以及细胞组织学相关性分析。
细胞组织学相关性为81.94%。假阳性率为5.56%，假阴性率为13.2%。敏感性为86.7%，阳性预测值为93.6%。女性的发病高峰年龄为31 - 40岁，男性为41 - 60岁。我们的患者中有7例年龄小于20岁（10%）。
FNAC是早期诊断PTC不可或缺的工具。然而，甲状腺的某些情况可能会导致诊断困境。病理学家对这些陷阱的认识可以防止误诊，并为患者提供更好的治疗。PTC发病率的增加，尤其是年轻人群中更为显著的增加，使得由于该年龄组预后较好，早期诊断变得更加重要。
