Xiong Yan, Yan Limin, Nong Lin, Zheng Yalin, Li Ting
Department of Pathology, Peking University First Hospital, 7 Xishiku Street, Xicheng District, Beijing, 100034, China.
Department of Pathology, Tangshan Gongren Hospital, 27 Wenhua Road, Lubei District, Hebei, 063000, China.
Diagn Pathol. 2019 Feb 2;14(1):10. doi: 10.1186/s13000-019-0786-4.
Pathological diagnosis based on core needle biopsy (CNB) should be different from a resected specimen because it is difficult to apply the histological criteria established for resected specimens to CNB due to sampling limitations. A pathological classification for thyroid nodule on CNB was first proposed by the Korean Group in 2015. The objective of this study was to test the reliability and clinical value of this proposal.
According to the Korean proposal, the CNB diagnoses were categorized into unsatisfactory, benign, indeterminate, follicular neoplasm, suspicious for malignancy and malignant. A comparative study between the diagnoses of CNB and resected specimens was performed.
The consistency was moderate (κ = 0.448). Combined indeterminate, suspicious for malignancy and malignant into a single group collectively referred to as "malignant" with the remaining merged into "others", CNB demonstrated a 95.93% sensitivity, 97.30% specificity, 62.07% accuracy, 99.81% positive predictive value (PPV) and 62.07% negative predictive value (NPV) for preoperative malignancy evaluation.
The Korean proposal for pathological classification of thyroid nodules on CNB is objective, operable and highly valuable.
基于粗针穿刺活检（CNB）的病理诊断应与切除标本的诊断有所不同，因为由于取样限制，难以将针对切除标本建立的组织学标准应用于CNB。韩国研究团队于2015年首次提出了CNB甲状腺结节的病理分类。本研究的目的是检验该提议的可靠性和临床价值。
根据韩国的提议，将CNB诊断分为不满意、良性、不确定、滤泡性肿瘤、可疑恶性和恶性。对CNB诊断与切除标本诊断进行了对比研究。
一致性为中等（κ = 0.448）。将不确定、可疑恶性和恶性合并为一组，统称为“恶性”，其余合并为“其他”，CNB对术前恶性评估的敏感性为95.93%，特异性为97.30%，准确性为62.07%，阳性预测值（PPV）为99.81%，阴性预测值（NPV）为62.07%。
韩国关于CNB甲状腺结节病理分类的提议客观、可操作且具有很高的价值。
