Harach H R
Pathology Service, Metabolism Hospital, Salta, Argentina.
Acta Cytol. 1989 Jan-Feb;33(1):31-5.
The accuracy of fine needle aspiration (FNA) cytology of the thyroid was addressed in 142 nodular goiters from an endemic goiter region. The aspirations and their interpretation were based on the methodology of the Karolinska Hospital. For practical purposes, the follicular lesions were divided into type I (benign), type II (atypical benign) and type III (suspicious). Excluding the follicular lesions, the cytohistologic agreement for the whole series was 87%, with a correlation of 81.5% for carcinomas. The type I and type II follicular lesions were benign on histologic grounds; 39% of the carcinomas were detected in the type III follicular lesions. The 0.7% false-positive diagnoses increased to 15% when type III follicular lesions were included. No false negatives were recorded. These observations, together with the increase of surgically resected thyroid carcinomas after FNA was accepted as a diagnostic modality, indicate that FNA biopsy of the thyroid is an accurate diagnostic method and is useful in selecting patients for subsequent surgery in areas of endemic goiter.
在一个地方性甲状腺肿流行地区的142例结节性甲状腺肿患者中，对甲状腺细针穿刺（FNA）细胞学检查的准确性进行了研究。穿刺及结果判读均依据卡罗林斯卡医院的方法。为便于实际应用，将滤泡性病变分为I型（良性）、II型（非典型良性）和III型（可疑）。排除滤泡性病变后，整个系列的细胞组织学符合率为87%，癌的符合率为81.5%。I型和II型滤泡性病变组织学上为良性；39%的癌在III型滤泡性病变中被检出。当纳入III型滤泡性病变时，假阳性诊断率从0.7%增至15%。未记录到假阴性病例。这些观察结果，以及FNA被接受为一种诊断方法后手术切除的甲状腺癌数量增加的情况，表明甲状腺FNA活检是一种准确的诊断方法，有助于在地方性甲状腺肿地区选择后续手术的患者。
