795 例行甲状腺切除术患者的甲状腺细针抽吸活检的组织病理学结果比较。

The comparison of the histopathological results of the thyroid fine-needle aspiration biopsies in the 795 patients with thyroidectomy.

机构信息

Department of General Surgery, University of Health Sciences Turkey, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey.

Department of Pathology, University of Health Sciences Turkey, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey.

出版信息

Diagn Cytopathol. 2021 Jun;49(6):671-676. doi: 10.1002/dc.24718. Epub 2021 Feb 9.

DOI:10.1002/dc.24718

PMID:33560593

Abstract

BACKGROUND

We aimed to evaluate the effectiveness of preoperative fine-needle aspiration biopsies (FNAB) by the postthyroidectomy pathology results.

METHOD

Seven hundred and ninety-five patients with FNAB and following thyroid operations which have been performed between April 2008 and December 2019 were included in this study. By comparing the results of the FNAB and final pathologies, the specificity, sensitivity, FNR, false positivity ratio (FPR), accuracy and also the effect of nodule diameter on these have been evaluated. In Bethesda III subgroup according to FNAB, we investigated the malignancy rates and in whom this risk has been increased more.

RESULTS

In our study, the sensitivity of FNAB is 73.40%, the specificity is 95.33%, the accuracy is 91.81%, FNR is 26.60% and FPR is 4.67%. In the patients with nodules ≥4 cm and < 4 cm respectively, we calculated the sensitivity 20.0% vs 79.76%, specificity 95.73% vs 95.19%, accuracy 89.82% vs 92.78%, FNR 80.0% vs 20.24%, FPR 4.27% vs 4.8%.

CONCLUSION

Thyroid FNAB is an easy procedure with a high specificity and sensitivity. Nevertheless, when the nodule diameter was ≥4 cm, increased FNR and decreased sensitivity should be kept in mind while evaluating the patients.

摘要

背景

本研究旨在通过甲状腺切除术后的病理结果评估术前细针穿刺活检（FNAB）的有效性。

方法

本研究纳入了 2008 年 4 月至 2019 年 12 月期间进行 FNAB 及随后甲状腺手术的 795 例患者。通过比较 FNAB 和最终病理结果，评估了 FNAB 的特异性、敏感性、假阴性率（FNR）、假阳性率（FPR）、准确性，以及结节直径对这些指标的影响。在 FNAB 按 Bethesda 分级为 III 级的亚组中，我们研究了恶性肿瘤的发生率以及哪些患者的风险更高。

结果

在本研究中，FNAB 的敏感性为 73.40%，特异性为 95.33%，准确性为 91.81%，FNR 为 26.60%，FPR 为 4.67%。在结节直径≥4cm 和<4cm 的患者中，我们计算出的敏感性分别为 20.0%和 79.76%，特异性分别为 95.73%和 95.19%，准确性分别为 89.82%和 92.78%，FNR 分别为 80.0%和 20.24%，FPR 分别为 4.27%和 4.8%。