Smeds S, Lennquist S
Department of Surgery, University Hospital, Linköping, Sweden.
Eur J Cancer Clin Oncol. 1988 Feb;24(2):293-7. doi: 10.1016/0277-5379(88)90271-4.
In the hands of an experienced cytologist aspiration cytology is a safe and hitherto the best diagnostic tool in the evaluation of nodular thyroid lesions. In histologically verified case series 50-90% of confirmed thyroid cancers can be detected by aspiration biopsy, the sensitivity being dependent on sampling errors, microscopic misinterpretation and the variation in attitude towards indeterminate diagnosis in the decision for diagnostic surgery. The number of proven benign cases that are correctly identified as such by biopsy varies accordingly and approx. 75% (specificity). In comparison with imaging procedures, including those giving information of functional activity, the combined sensitivity and specificity rates of aspiration cytology come closest to the ideal discriminatory situation. In combination with case history and careful clinical examination, fine needle aspiration cytology is the best guidance for an optimal selection of patients for therapeutic or diagnostic surgery. Future development of sensitive markers for malignant degeneration will probably increase the selective power of this diagnostic technique.
在经验丰富的细胞学家手中，针吸细胞学检查是评估甲状腺结节性病变的一种安全且迄今为止最好的诊断工具。在组织学确诊的病例系列中，50% - 90%的确诊甲状腺癌可通过穿刺活检检测到，其敏感性取决于采样误差、显微镜下的错误解读以及在决定进行诊断性手术时对不确定诊断的态度差异。活检正确识别为良性的已证实病例数量也相应有所不同，约为75%（特异性）。与包括提供功能活性信息的成像检查相比，针吸细胞学检查的综合敏感性和特异性最接近理想的鉴别情况。结合病史和仔细的临床检查，细针穿刺细胞学检查是为治疗性或诊断性手术最佳选择患者的最佳指导。恶性变性敏感标志物的未来发展可能会提高这种诊断技术的筛选能力。
