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甲状腺细针穿刺细胞学检查在儿科甲状腺结节治疗及随访中的作用

THE ROLE OF THYROID FINE-NEEDLE ASPIRATION CYTOLOGY IN THE TREATMENT AND FOLLOW-UP OF THYROID NODULES IN THE PEDIATRIC POPULATION.

作者信息

Kardelen Al A D, Yılmaz C, Poyrazoglu S, Tunca F, Bayramoglu Z, Bas F, Bundak R, Gilse Senyurek Y, Ozluk Y, Yegen G, Yeşil S, Darendeliler F

机构信息

Istanbul University - Pediatric Endocrinology, Istanbul, Turkey.

Istanbul University - Pediatrics, Istanbul, Turkey.

出版信息

Acta Endocrinol (Buchar). 2019 Jul-Sep;15(3):333-341. doi: 10.4183/aeb.2019.333.

Abstract

OBJECTIVE

Thyroid fine-needle aspiration (FNA) and cytology is a reliable diagnostic method used in the assessment of malignancy when evaluating thyroid nodules, in conjunction with clinical and ultrasonographic findings. The aim of this study is to compare clinical, ultrasonographic, cytological and histopathological findings in children who underwent thyroid FNA.

METHODS

Subjects comprised 80 patients (52 female) aged 13.7±2.8 years at the time of FNA who where evaluated for thyroid nodules. Clinical, ultrasonographic and cytological findings of patients were evaluated retrospectively.

RESULTS

Autoimmune thyroiditis was present in 30% and history of radiotherapy to the head or neck in 10%. The cytological diagnosis of patients included: inadequate or hemorrhagic sample in 10%; benign in 42.5%; atypia or follicular lesion of undetermined significance (AUS/FLUS) in 15%; suspicion of follicular neoplasia (SFN) in 7.5%; suspicion of malignancy (SM) in 8.8%; and malignant in 16.3%. Thirty-seven patients underwent thyroidectomy. Malignancy rates for histopathologic follow-up were 75%, 85.7% and 100% for SFN, SM and malignant categories, respectively. Only one benign and two AUS/FLUS FNAs were found to be malignant on histopathological examination. Among patients who had received radioiodinetherapy, 87.5% had malignancy. In this study, the sensitivity of FNA was 96%, specificity 50%, positive predictive value 90.9%, negative predictive value 75%, and diagnostic value of FNA was 89.2%.

CONCLUSION

Thyroid FNA results were highly compatible with histopathological examination. Sensitivity, positive predictive value and diagnostic value of FNA were high.

摘要

目的

甲状腺细针穿刺抽吸活检(FNA)及细胞学检查是一种可靠的诊断方法,在结合临床及超声检查结果评估甲状腺结节的恶性程度时使用。本研究旨在比较接受甲状腺FNA的儿童的临床、超声、细胞学及组织病理学检查结果。

方法

研究对象包括80例在FNA时年龄为13.7±2.8岁的患者(52例女性),这些患者因甲状腺结节接受评估。对患者的临床、超声及细胞学检查结果进行回顾性评估。

结果

30%的患者存在自身免疫性甲状腺炎,10%的患者有头颈部放疗史。患者的细胞学诊断包括:样本不足或出血占10%;良性占42.5%;非典型或意义未明的滤泡性病变(AUS/FLUS)占15%;可疑滤泡性肿瘤(SFN)占7.5%;可疑恶性(SM)占8.8%;恶性占16.3%。37例患者接受了甲状腺切除术。SFN、SM及恶性类别患者的组织病理学随访恶性率分别为75%、85.7%及100%。组织病理学检查发现,仅1例良性及2例AUS/FLUS FNA为恶性。在接受放射性碘治疗的患者中,87.5%患有恶性肿瘤。本研究中,FNA的敏感性为96%,特异性为50%,阳性预测值为90.9%,阴性预测值为75%,FNA的诊断价值为89.2%。

结论

甲状腺FNA结果与组织病理学检查高度相符。FNA的敏感性、阳性预测值及诊断价值较高。

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