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甲状腺细针穿刺活检:大学医院经验

Fine needle thyroid aspiration: university hospital experience.

作者信息

Baco F P, Diaz D, Aguilo F, Villamarzo G, Torres L, Rodriguez R

机构信息

Department of Medicine, School of Medicine, San Juan, PR.

出版信息

P R Health Sci J. 1987 Aug;6(2):81-4.

PMID:3671658
Abstract

Fine needle thyroid aspiration (FNTA) as a diagnostic tool of thyroid disease was started at the University District Hospital (UDH) in 1983. FNTA was performed in 54 willing patients from December 1984 through December 1985. If no medical contraindications existed, thyroid surgery was recommended in order to assess diagnostic accuracy. Surgery was done in 34 (63%) patients; while not in 20:3 for medical reasons, 2 lost to follow-up, 3 refused, 7 had inappropriate FNTA, and 5 for unknown reasons. None had complications to FNTA. Cytology was classified as Class O: inadequate; Class 1: benign; Class 2: indeterminate; and Class 3: malignant. "Non-benign" cytology was obtained in 14 patients: 7 indeterminate (class 2) and 7 malignant (class 3). Four of these had carcinoma confirmed by surgery. Of the 19 with benign FNTA (class 1) only one has thyroid carcinoma. One patient had inadequate sample (Class O). The sensitivity was 80%, specificity 65%, and diagnostic accuracy 67%. All these statistical values are within the range reported in fifteen reviewed series. Thus, FNTA at UDH had a diagnostic value comparable to that described in the literature. It may be utilized as a safe, reliable tool complementary to clinical data in order to reduce the amount of unnecessary thyroid surgery, carry out earlier diagnoses of malignant nodules and increase the yield of carcinoma among those operated.

摘要

1983年,细针甲状腺穿刺抽吸术(FNTA)作为甲状腺疾病的诊断工具在大学区医院(UDH)开始应用。1984年12月至1985年12月期间,对54名自愿参与的患者进行了FNTA。若不存在医学禁忌证,建议进行甲状腺手术以评估诊断准确性。34名(63%)患者接受了手术;20名未接受手术,其中3名因医学原因,2名失访,3名拒绝,7名FNTA不恰当,5名原因不明。所有患者均未出现FNTA相关并发症。细胞学检查结果分为O级:不充分;1级:良性;2级:不确定;3级:恶性。14名患者的细胞学检查结果为“非良性”:7名不确定(2级)和7名恶性(3级)。其中4名经手术确诊为癌症。19名FNTA结果为良性(1级)的患者中只有1名患有甲状腺癌。1名患者样本不充分(O级)。敏感性为80%,特异性为65%,诊断准确性为67%。所有这些统计值均在15篇综述系列报道的范围内。因此,UDH的FNTA具有与文献中描述相当的诊断价值。它可作为一种安全、可靠的工具,辅助临床数据,以减少不必要的甲状腺手术数量,更早地诊断恶性结节,并提高手术患者中癌症的检出率。

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