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择期甲状腺手术患者细针穿刺抽吸细胞病理学与甲状腺组织病理学检查的比较:我们还需要细针穿刺抽吸细胞病理学吗?

Comparison of Fine-Needle Aspiration Cytopathology with Histopathological Examination of the Thyroid Gland in Patients Undergoing Elective Thyroid Surgery: Do We Still Need Fine-Needle Aspiration Cytopathology?

作者信息

Gąsiorowski Oskar, Leszczyński Jerzy, Kaszczewska Joanna, Stępkowski Kamil, Kaszczewski Piotr, Baryła Maksymilian, Gałązka Zbigniew

机构信息

Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, ul. Żwirki i Wigury 61, 02-091 Warsaw, Poland.

出版信息

Diagnostics (Basel). 2024 Jan 23;14(3):236. doi: 10.3390/diagnostics14030236.

Abstract

BACKGROUND

The thyroid gland is responsible for various functions, but it is susceptible to pathologies. The gold standard for preliminarily diagnosing thyroid abnormalities is fine-needle aspiration cytology (FNAC), although it has some limitations; thus, postoperative histopathological examination confirms the diagnosis. The aim of the present study was to compare preoperative FNAC results with postoperative histopathological examination.

METHODS

This study is a retrospective study based on FNAC and postoperative histopathology examination, which were compared and analyzed.

RESULTS

This study included 344 patients between 18 and 86 years old (mean age: 53.06 ± 13.89), comprising 274 females and 70 males (mean ages 52.72 ± 13.86 and 54.39 ± 14.05, respectively) with a 3.9:1 female-to-male ratio. Statistical significance between the FNAC and histopathology results was observed ( = 0.0000), and 86 (25.00%) patients were found to have been diagnosed incorrectly based on FNAC. The sensitivity of FNAC was 92.31%, and its specificity was 82.08%, with positive and negative predictive values of 68.57% and 96.08%, respectively.

CONCLUSIONS

Due to many factors, FNAC may lead to over- or under-diagnosis, increasing the chances of complications associated with the selected treatment. However, we do not have any other more accurate tools; therefore, FNAC should still remain as the gold standard of preliminary examination.

摘要

背景

甲状腺负责多种功能,但易患多种疾病。尽管细针穿刺细胞学检查(FNAC)存在一些局限性,但其仍是初步诊断甲状腺异常的金标准;因此,术后组织病理学检查可确诊。本研究的目的是比较术前FNAC结果与术后组织病理学检查结果。

方法

本研究是一项基于FNAC和术后组织病理学检查的回顾性研究,对二者进行比较和分析。

结果

本研究纳入了344例年龄在18至86岁之间的患者(平均年龄:53.06±13.89岁),其中女性274例,男性70例(平均年龄分别为52.72±13.86岁和54.39±14.05岁),男女比例为3.9:1。观察到FNAC结果与组织病理学结果之间存在统计学差异(=0.0000),发现86例(25.00%)患者基于FNAC被误诊。FNAC的敏感性为92.31%,特异性为82.08%,阳性预测值和阴性预测值分别为68.57%和96.08%。

结论

由于多种因素,FNAC可能导致过度诊断或诊断不足,增加所选治疗相关并发症的发生几率。然而,我们没有其他更准确的工具;因此,FNAC仍应作为初步检查的金标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f33c/10854902/8d6ab4159169/diagnostics-14-00236-g001.jpg

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