Schmid K W, Lucciarini P, Ladurner D, Zechmann W, Hofstädter F
Department of Surgery, University of Innsbruck, Austria.
Acta Cytol. 1987 Sep-Oct;31(5):591-4.
From 1979 to 1983, 94 papillary carcinomas of the thyroid gland were examined histologically in our institute after a preoperative cytologic examination. Material for cytologic examination was obtained using fine needle aspiration (FNA) biopsy. Eighty-five (90.4%) of the 94 examined cytologic smears were representative. Among these 85 cases suspicion for malignancy or malignancy itself was found in 64 cases (75.3%). The remaining 21 smears, classified as cytologically not as suspect for malignancy, were reclassified and the previous diagnosis had to be revised in one case. In the other 20 cases no clue for malignancy could be demonstrated even after reexamination. In the 85 cases with representative cytologic findings, tumor size was determined on surgical material, in order to establish how many carcinomas with a diameter less than 3 cm could not be reached by FNA biopsy. Except for one case, all carcinomas with negative preoperative cytologic findings had a diameter less than or equal to 3 cm. The question arising is the possibility of improving the accuracy of FNA biopsy in tumor detection within cold nodules of the thyroid by combined use of scintigraphy and ultrasound-guided FNA biopsy.
1979年至1983年期间，我院对94例甲状腺乳头状癌进行了术前细胞学检查后再行组织学检查。细胞学检查材料通过细针穿刺（FNA）活检获取。94例经检查的细胞学涂片中有85例（90.4%）具有代表性。在这85例中，64例（75.3%）发现有恶性可疑或确诊为恶性。其余21例涂片在细胞学上未被归类为恶性可疑，经重新分类后，其中1例之前的诊断必须修正。在另外20例中，即使重新检查后也未发现恶性线索。在85例具有代表性细胞学结果的病例中，根据手术材料确定肿瘤大小，以确定有多少直径小于3cm的癌无法通过FNA活检检测到。除1例外，所有术前细胞学检查结果为阴性的癌直径均小于或等于3cm。由此产生的问题是，通过联合使用闪烁扫描和超声引导下的FNA活检，是否有可能提高FNA活检在甲状腺冷结节肿瘤检测中的准确性。
