细针穿刺活检（FNAB）在甲状腺闪烁造影冷结节鉴别诊断中的价值

The Value of Fine-Needle Aspiration Biopsy (FNAB) in Differential Diagnosis of Scintigraphic Cold Thyroid Nodule.

作者信息

Sulejmanovic Maja, Cickusic Amra Jakubovic, Salkic Sabina

机构信息

Radiology and Nuclear Medicine Clinic, Department for Thyroid Diseases, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.

General/Family Medical Services, Public Healthcare Institution, Medical Centre Tuzla, Tuzla, Bosnia and Herzegovina.

出版信息

Acta Inform Med. 2019 Jun;27(2):114-118. doi: 10.5455/aim.2019.27.114-118.

DOI:10.5455/aim.2019.27.114-118

PMID:31452569

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6689332/

Abstract

INTRODUCTION

Pathology of thyroid nodules is present in all ages and it is frequently encountered in clinical practice. Thyroid nodules do not represent a single disease, but they are the clinical manifestation of a wide range of different thyroid diseases.

AIM

The objective of this study is to evaluate the frequency and localization of malignancy in solitary scintigraphic cold nodules, as well as the sensitivity, specificity and diagnostic accuracy of FNAB in comparison with histopathological findings.

METHODS

The study was included 49 patients with palpatory findings of the solitary nodule located in the both lobes or isthmus of thyroid gland. All subjects underwent the scintigraphy and FNAB, followed by a cytologic results that was compared to the final histopathological diagnosis, after surgery.

RESULTS

The study results show that the highest number of solitary nodules (81,6%) is localized in the lower pole of the both lobes of the thyroid gland. The cytologic results were benign 8 cases, malignant in 23 and indeterminate (follicular neoplasm) in 18 cases. The highest number of thyroid cancer is histopathologically confirmed in the patients with cytological diagnosis of follicular neoplasms, i.e. follicular cancer is found in 66.7% and papillary cancer is found in 33.3% of subjects. The most common cancer is papillary cancer found in 61,2%. Since the pathohistological diagnosis of all our patients responded to cancer, it was done indirect statistical evaluation of the diagnostic sensitivity of cytological method in the estimation of malignant thyroid lesion, which was 83,7%.

CONCLUSION

FNAB is a highly sensitive method in the diagnostics of malignant thyroid lesions with the sensitivity Se=83,7%. The highest number of thyroid cancer is histopathologically confirmed in the patients with cytological diagnosis of follicular neoplasm (66.7%). The highest number of patients had a cytological diagnosis of papillary cancer.

摘要

引言

甲状腺结节的病理情况在各年龄段均有出现，在临床实践中较为常见。甲状腺结节并非单一疾病，而是多种不同甲状腺疾病的临床表现。

目的

本研究的目的是评估孤立性甲状腺冷结节中恶性病变的发生率和部位，以及细针穿刺抽吸活检（FNAB）相对于组织病理学结果的敏感性、特异性和诊断准确性。

方法

该研究纳入了49例甲状腺两叶或峡部可触及孤立性结节的患者。所有受试者均接受了闪烁扫描和FNAB，然后将细胞学结果与术后最终的组织病理学诊断进行比较。

结果

研究结果显示，大多数孤立性结节（81.6%）位于甲状腺两叶的下极。细胞学结果为良性的有8例，恶性的有23例，不确定（滤泡性肿瘤）的有18例。在细胞学诊断为滤泡性肿瘤的患者中，组织病理学确诊的甲状腺癌数量最多，即66.7%的受试者为滤泡癌，33.3%为乳头状癌。最常见的癌症是乳头状癌，占61.2%。由于我们所有患者的病理组织学诊断均为癌症，因此对细胞学方法在评估甲状腺恶性病变中的诊断敏感性进行了间接统计评估，结果为83.7%。