Oo Zun Pwint, Hlaing Aung Myo, Kyi Khin Chaw Su, Fukuoka Junya, Bychkov Andrey
Department of Pathology, University of Medicine, Mandalay, Myanmar.
Department of Pathology, University of Pharmacy, Yangon, Myanmar.
Gland Surg. 2020 Oct;9(5):1747-1753. doi: 10.21037/gs-20-414.
Fine-needle aspiration cytology (FNAC) of the thyroid is a widely accepted method for aiding the diagnosis of thyroid nodules. In Myanmar, it has been done since the early 1990s, and mainly performed by surgeons and otorhinolaryngologists. The interpretation of cytology is solely made by pathologists. Although some of the experts particularly those from specialist hospitals use the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), many still prefer the British five-tier cytopathology report. Available local publications addressing the accuracy of FNAC and cytologic-histologic correlations were queried. Ten studies performed in 1991-2018 on 540 thyroid nodules were included. Cytologic-histologic correlations showed a range of sensitivity from 64.29% to 100%, specificity from 93% to 100%, and diagnostic accuracy from 94% to 100%. The adoption of TBSRTC by pathologists is still slow and should be encouraged via seminars and training programs. Further multihospital-based large cohort studies with uniform design and adequate follow-up are needed to better promote and assess utility of thyroid FNAC in Myanmar.
甲状腺细针穿刺细胞学检查（FNAC）是一种广泛认可的辅助诊断甲状腺结节的方法。在缅甸，自20世纪90年代初以来就已开展此项检查，主要由外科医生和耳鼻喉科医生进行操作。细胞学检查结果仅由病理学家解读。尽管一些专家，特别是来自专科医院的专家使用《甲状腺细胞病理学报告贝塞斯达系统》（TBSRTC），但许多人仍然更喜欢英国的五级细胞病理学报告。我们检索了现有的关于FNAC准确性和细胞学与组织学相关性的本地出版物。纳入了1991年至2018年对540个甲状腺结节进行的10项研究。细胞学与组织学相关性显示，敏感性范围为64.29%至100%，特异性范围为93%至100%，诊断准确性范围为94%至100%。病理学家对TBSRTC的采用仍然缓慢，应通过研讨会和培训项目予以鼓励。需要进一步开展多中心、设计统一且随访充分的大型队列研究，以更好地推广和评估甲状腺FNAC在缅甸的实用性。
