Machała Ewa, Sopiński Jan, Iavorska Iulia, Kołomecki Krzysztof
Uniwersytet Medyczny w Łodzi Lekarski Klinika Chirurgii Endokrynologicznej, Ogólnej i Onkologicnej.
Uniwersytet Medyczny w Łodzi Lekarski Klinika Chirurgii Endokrynologicznej, Ogólnej i Onkologicznej.
Pol Przegl Chir. 2018 Aug 21;90(6):1-5. doi: 10.5604/01.3001.0012.4712.
Fine needle aspiration cytology (FNAC) is considered as the gold standard diagnostic test for the diagnosis of thyroid nodules. It is a cost-effective procedure that provides specific diagnosis rapidly with minimal complications. It plays an important role in the determination of treatment- patients with suspected malignancy diagnosis can be subjected to surgery. On the other hand it can decrease the rate of unnecessary surgeries.
The aim of this study was to evaluate and compare the correlation, accuracy of fine needle aspirational cytology (FNAC) in the diagnosis of thyroid lesions with the final histopathologic diagnosis in the surgical specimens.
In our study we have performed a retrospective analysis of a case series of patients who were admitted to the Department of Endocrine, General and Oncological Surgery of Hospital of M. Kopernik in Łodź (Poland) between May 2016 and December 2017 and underwent FNAC with subsequent surgery. Cytological diagnosis was classified into six Bethesda categories.
On cytological examination 1070/1262 were reported as benign, 49 malignant and 143 suspicious. On histopathological examination, 956/1070 cases were confirmed as benign but there were 114 discordant cases. Among the other cases histopathology diagnosis of malignancy matched in 45/49 and 128/143 cases.The sensitivity and specificity were 60,28% and 98,05% respectively. False positive rate was 1.95% and false negative rate was 39.72%. The positive predictive value was 90.1% and negative predictive value was 89.35%. Accuracy of FNA in differentiating benign from malignant thyroid lesions was 89,46%.
Fine needle aspiration cytology is a simple, cost-effective and popular procedure for the diagnosis of thyroid cancer. It is recommended as the first line investigation for the diagnosis of thyroid lessions.
细针穿刺抽吸活检(FNAC)被认为是诊断甲状腺结节的金标准诊断测试。它是一种经济有效的检查方法,能快速提供明确诊断,且并发症极少。它在治疗决策中起着重要作用——疑似恶性肿瘤诊断的患者可接受手术。另一方面,它可以降低不必要的手术率。
本研究的目的是评估和比较细针穿刺抽吸活检(FNAC)在甲状腺病变诊断中的相关性、准确性与手术标本最终组织病理学诊断的相关性、准确性。
在我们的研究中,我们对2016年5月至2017年12月期间入住罗兹(波兰)哥白尼医院内分泌、普通和肿瘤外科的一系列病例进行了回顾性分析,这些患者均接受了FNAC并随后进行了手术。细胞学诊断分为六个贝塞斯达类别。
细胞学检查报告1070/1262例为良性,49例为恶性,143例为可疑。组织病理学检查显示,956/1070例被确认为良性,但有114例不一致病例。在其他病例中,恶性肿瘤的组织病理学诊断在45/49例和128/143例中相符。敏感性和特异性分别为60.28%和98.05%。假阳性率为1.95%,假阴性率为39.72%。阳性预测值为90.1%,阴性预测值为89.35%。FNA区分甲状腺良性和恶性病变的准确率为89.46%。
细针穿刺抽吸活检是一种简单、经济有效且常用的甲状腺癌诊断方法。建议将其作为甲状腺病变诊断的一线检查方法。