Kuzan Taha Yusuf, Canbey Goret Ceren
Department of Radiology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey.
Department of Surgical Pathology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Istanbul, Turkey.
Eur Thyroid J. 2020 Jan;9(1):49-54. doi: 10.1159/000504094. Epub 2019 Oct 30.
Ultrasound-guided fine-needle aspiration biopsy (FNAB) is a reliable, minimally invasive diagnostic method with high sensitivity and specificity in the evaluation of thyroid nodules. Our aim in this retrospective study was to determine if there was a difference in the adequacy ratio based on the number of needle passes in the thyroid FNABs in the absence of rapid on-site evaluation (ROSE) by the pathologist and to determine the optimal needle pass number for FNAB.
Between November 2018 and February 2019, thyroid FNABs of 121 (99 female, 22 male) patients were evaluated retrospectively. Samples for each biopsy were numbered according to the order of retrieval, and 4 pairs of slides were prepared by the radiologist without on-site microscopic evaluation. Cytological results were determined according to the Bethesda classification.
The rate of adequacy in the first, second, third, and fourth passes were 76.0, 82.6, 77.7, and 71.2%, respectively. No statistically significant difference was found between these four groups in terms of adequacy ( = 0.21). The adequacy rates of the 1st, 1st+2nd, 1st+2nd+3rd, and cumulative evaluation of all four biopsies were 76.0, 87.6, 90.1, and 91.7%, respectively ( = 0.001). A statistically significant difference was found in the comparison of the 1st biopsy and the cumulative 1st+2nd biopsy in terms of adequacy rates ( = 0.019). However, there was no statistically significant difference between the cumulative 1st+2nd biopsy and the cumulative 1st+2nd+3rd biopsy in terms of adequacy rates ( = 0.54).
In cases where ROSE cannot be performed, we recommend a minimum of 2 and a maximum of 3 needle entries for FNAB adequacy with the right technique and preparation.
超声引导下细针穿刺活检（FNAB）是一种可靠的微创诊断方法，在评估甲状腺结节时具有高敏感性和特异性。本回顾性研究的目的是确定在病理学家未进行快速现场评估（ROSE）的情况下，甲状腺FNAB中基于穿刺针数的取材充足率是否存在差异，并确定FNAB的最佳穿刺针数。
回顾性评估2018年11月至2019年2月期间121例患者（99例女性，22例男性）的甲状腺FNAB。每次活检的样本按取材顺序编号，放射科医生在无现场显微镜评估的情况下制备4对玻片。根据贝塞斯达分类法确定细胞学结果。
第一次、第二次、第三次和第四次穿刺的取材充足率分别为76.0%、82.6%、77.7%和71.2%。这四组在取材充足率方面未发现统计学上的显著差异（P = 0.21）。第一次、第一次 + 第二次、第一次 + 第二次 + 第三次以及所有四次活检的累积评估的取材充足率分别为76.0%、87.6%、90.1%和91.7%（P = 0.001）。在取材充足率方面，第一次活检与累积的第一次 + 第二次活检的比较发现有统计学上的显著差异（P = 0.019）。然而，累积的第一次 + 第二次活检与累积的第一次 + 第二次 + 第三次活检在取材充足率方面没有统计学上的显著差异（P = 0.54）。
在无法进行ROSE的情况下，我们建议采用正确的技术和准备，FNAB取材充足的穿刺针数最少为2针，最多为3针。
