Serviço de Endocrinologia e Metabologia, Hospital de Clínicas, Universidade Federal do Paraná (SEMPR), Curitiba, PR, Brasil,
Universidade Estadual do Oeste do Paraná (Unioeste), Cascavel, PR, Brasil.
Arch Endocrinol Metab. 2021 Nov 1;65(1):40-48. doi: 10.20945/2359-3997000000320. Epub 2021 Jan 14.
To verify the cytopathological Bethesda System classification of thyroid nodule fine-needle aspiration biopsy (FNAB) in MTC patients and to assess the role of preoperative serum calcitonin (CT) levels in the investigation of this neoplasm in medullary thyroid cancer (MTC) patients under observation at the Uopeccan ().
This is a cross-sectional review of medical records of patients monitored at the thyroid cancer outpatient clinic of Uopeccan. Clinical and demographic data, laboratory tests, ultrasound images, and cytopathological findings of MTC patients were evaluated.
Among the 360 patients with thyroid cancer monitored in the outpatient clinic, 5.2% (n: 19/360) had MTC. The hereditary form was more prevalent (63.2%), and there was no sex preference. The most common ultrasound findings were hypoechogenicity, solid appearance and microcalcifications. The FNAB diagnoses showed a sensitivity of 47.1%, and the most common cytopathological report was Bethesda category III. Serum CT levels showed good sensitivity (84.6%) for the diagnosis of MTC, and sensitivity levels were directly associated with the size of the nodule and distant metastases.
Bethesda category III was more prevalent in this group of MTC patients. Serum CT levels were more sensitive than cytopathology for diagnosis of this neoplasm and were able to identify all patients who could not be diagnosed by FNAB.
验证甲状腺结节细针抽吸活检（FNAB）在 MTC 患者中的细胞病理学 Bethesda 系统分类，并评估术前降钙素（CT）水平在观察性髓样甲状腺癌（MTC）患者中的作用。
这是对 Uopeccan 甲状腺癌门诊监测的 MTC 患者的病历进行的一项横断面回顾性研究。评估了 MTC 患者的临床和人口统计学数据、实验室检查、超声图像和细胞病理学结果。
在门诊监测的 360 例甲状腺癌患者中，5.2%（n：19/360）为 MTC。遗传性形式更为常见（63.2%），无性别偏好。最常见的超声表现为低回声、实性外观和微钙化。FNAB 诊断的敏感性为 47.1%，最常见的细胞病理学报告为 Bethesda 类别 III。血清 CT 水平对 MTC 的诊断具有良好的敏感性（84.6%），并且敏感性水平与结节大小和远处转移直接相关。
在该组 MTC 患者中，Bethesda 类别 III 更为常见。与 FNAB 相比，血清 CT 水平对该肿瘤的诊断更为敏感，并且能够识别所有不能通过 FNAB 诊断的患者。
