Rabal Fueyo Antonio, Vilanova Serra Magdalena, Lerma Puertas Enrique, Montserrat Esplugas Enrique, Pérez García José Ignacio, Mato Matute Eugenia, De Leiva Hidalgo Alberto, Moral Duarte Antonio
Department of General Surgery Hospital de la Santa Creu i Sant Pau Barcelona Spain.
Department of Pathology Hospital de la Santa Creu i Sant Pau Barcelona Spain.
Endocrinol Diabetes Metab. 2018 Jun 19;1(3):e00024. doi: 10.1002/edm2.24. eCollection 2018 Jul.
Ultrasonography and cytology obtained by fine-needle aspiration are part of the basic study of the thyroid nodule. Although they are not diagnostic in every case, they are cost-effective methods that inform surgical treatment and its extent. The purpose of this study was to evaluate the accuracy of ultrasonography associated with fine-needle aspiration to predict malignancy in nodular thyroid pathology.
We collected prospective data from patients undergoing thyroidectomy by single nodule or multinodular goitre between 2006 and 2016. A total of 417 patients were included. Ultrasounds were classified as suspected of malignancy if they had 2 or more of the following characteristics: hypoechogenicity, microcalcifications, intranodular central hypervascularization, irregular margins and poorly defined edges.
Ultrasound and fine-needle aspiration accuracy.
In the postoperative study, 40% presented malignant pathology. 33% of patients with nonsuspicious ultrasound and 73% of those with suspicious ultrasound had malignant disease. Among patients with single nodule and suspicious ultrasound, the malignancy rate reached 80%. As for cytology, 100% of Bethesda VI patients, 88% of V, 63% of IV, 31% of III and 12% of II were found to have carcinoma. The combination of the 2 tests showed a high predictive value, particularly in cases of Bethesda IV cytology.
Thyroid cytology provides high predictive value of the presence of carcinoma. The predictive value of ultrasound is also high, mainly in the study of isolated nodules. The combination of the 2 tests results in increased diagnostic accuracy.
超声检查和细针穿刺获取的细胞学检查是甲状腺结节基础研究的一部分。尽管它们并非在每种情况下都具有诊断性，但却是有助于指导手术治疗及其范围的经济有效的方法。本研究的目的是评估超声检查联合细针穿刺预测甲状腺结节性病变恶性程度的准确性。
我们收集了2006年至2016年间因单发结节或多结节性甲状腺肿接受甲状腺切除术患者的前瞻性数据。共纳入417例患者。如果超声具有以下2种或更多特征，则被分类为怀疑恶性：低回声、微钙化、结节内中央血管增多、边界不规则和边缘不清。
超声和细针穿刺的准确性。
在术后研究中，40%呈现恶性病变。超声检查无可疑表现的患者中33%患有恶性疾病，超声检查有可疑表现的患者中73%患有恶性疾病。在单发结节且超声检查有可疑表现的患者中，恶性率达到80%。至于细胞学检查，贝塞斯达VI级患者中100%、V级患者中88%、IV级患者中63%、III级患者中31%和II级患者中12%被发现患有癌症。两种检查方法联合显示出较高的预测价值，尤其是在贝塞斯达IV级细胞学检查的病例中。
甲状腺细胞学检查对癌症的存在具有较高的预测价值。超声检查的预测价值也很高，主要在孤立结节的研究中。两种检查方法联合可提高诊断准确性。
