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甲状腺结节核心针活检 - 当前方法。

Thyroid nodule core needle biopsy - current approach.

机构信息

Department of Radiology, Ministry of Health Tuzla State Hospital, Istanbul, Türkiye.

Department of General Surgery, Medicana International Atasehir Hospital, Atasehir, Istanbul, Türkiye.

出版信息

Endokrynol Pol. 2023;74(6). doi: 10.5603/ep.97053. Epub 2023 Nov 23.

Abstract

Fine needle aspiration biopsy (FNAB) guided by ultrasonography is routinely used to identify thyroid nodules prior to surgery. Although FNAB has great diagnostic accuracy and safety, it is limited by its relatively low diagnostic accuracy in follicular lesions, such as non-diagnostic or atypia of unclear significance (AUS)/follicular lesion of uncertain significance (FLUS). Additional diagnostic tests are required to overcome these challenges in evaluating thyroid nodules. Thyroid nodules can now be diagnosed with spring-activated single- or double-action needles following the introduction of core needle biopsy (CNB). CNB has the ability to address the limitations of FNAB by obtaining a sizeable tissue sample with more details on the histological structure supporting the capsule and fewer non-diagnostic effects brought on by the absence of follicular cells. Compared to repeated FNAB, CNB has been demonstrated to produce fewer ambiguous results, such as non-diagnostic or AUS/FLUS results. The Korean Endocrine Pathology Thyroid CNB Working Group issued its first set of guidelines for "Pathology Reporting of Thyroid Core Needle Biopsy" in 2015. In 2017, the Korean Society of Thyroid Radiology (KSThR) published "Core Needle Biopsy of Thyroid: 2016 Consensus Statement and Recommendations from the Korean Society of Thyroid Radiology". The main objectives of thyroid CNB are to detect individuals with thyroid illness who require surgery and to obtain a significant number of thyroid lesions with low morbidity.

摘要

超声引导下细针抽吸活检(FNAB)通常用于手术前识别甲状腺结节。虽然 FNAB 具有很高的诊断准确性和安全性,但它在滤泡性病变(如无诊断意义或意义不明的非典型性(AUS)/滤泡性肿瘤不确定意义(FLUS))中的诊断准确性相对较低。需要额外的诊断测试来克服评估甲状腺结节时遇到的这些挑战。随着核心针活检(CNB)的引入,现在可以使用弹簧激活的单针或双针来诊断甲状腺结节。CNB 通过获取具有更多关于支持胶囊的组织学结构的详细信息的大量组织样本,并减少因缺乏滤泡细胞而导致的非诊断效果,从而克服了 FNAB 的局限性。与重复 FNAB 相比,CNB 已被证明可产生更少的模棱两可的结果,例如无诊断意义或 AUS/FLUS 结果。韩国内分泌病理学甲状腺 CNB 工作组于 2015 年发布了第一套“甲状腺核心针活检病理学报告”指南。2017 年,韩国甲状腺放射学会(KSThR)发布了“甲状腺核心针活检:2016 年韩国甲状腺放射学会共识声明和建议”。甲状腺 CNB 的主要目的是检测需要手术的甲状腺疾病患者,并获得大量具有低发病率的甲状腺病变。

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