索尔特帕斯液体细胞学与传统涂片在甲状腺抽吸标本中的诊断价值：单中心 13 年经验。

Diagnostic values of SurePath liquid-based cytology versus conventional smear in thyroid aspiration samples: A 13-year experience at a single institution.

机构信息

Division of Cytopathology, Department of Pathology, Chi Mei Medical Center, Tainan, Taiwan.

出版信息

Diagn Cytopathol. 2024 Jul;52(7):369-376. doi: 10.1002/dc.25319. Epub 2024 Apr 10.

DOI:10.1002/dc.25319

PMID:38595067

Abstract

BACKGROUND

Fine needle aspiration cytology (FNAC) is the most useful tool in the diagnosis of thyroid nodules. Liquid-based cytology (LBC) is replacing the conventional smear (CS) for evaluation of thyroid FNAC. In our institution, thyroid FNAC preparation was changed from CS to LBC SurePath in July 2016. This study aimed to compare the diagnostic value of SurePath with that of CS in thyroid lesions.

METHODS

A total of 35,406 samples of thyroid FNAC (11,438 CS and 23,968 SurePath), collected from January 2010 to December 2022, were included in this study. We also examined the malignant rate using the surgical pathology diagnosis as the gold standard.

RESULTS

The distribution of TBSRTC cytological categories was equivalent between CS and SurePath. The rate of nondiagnostic/unsatisfactory category was higher in CS compared to SurePath (43.4% vs. 22.3%; p < .05). After routine use of SurePath, the surgical resection rate was reduced from 12.0% to 8.6% (p < .05) and the malignant rate increased from 32.2% to 41.5% (p < .05). The sensitivities of CS and SurePath were 71.0% and 82.0%, respectively, and the specificities were 99.0% and 97.3%, respectively, whereas the positive predictive values were 97.8% and 96.8%, respectively, and the negative predictive values were 85.0% and 84.6%, respectively. Diagnostic accuracy of CS and SurePath were 88.5% and 89.7% respectively.

CONCLUSION

SurePath can increase the sample adequacy, increase the sensitivity and reduce the workload and avoid unnecessary surgeries with similar accuracy to CS.

摘要

背景

细针穿刺细胞学检查（FNAC）是诊断甲状腺结节最有用的工具。液基细胞学（LBC）正在取代传统涂片（CS）用于评估甲状腺 FNAC。在我们机构，甲状腺 FNAC 制片从 2016 年 7 月起从 CS 改为 LBC SurePath。本研究旨在比较 SurePath 与 CS 在甲状腺病变中的诊断价值。

方法

回顾性分析 2010 年 1 月至 2022 年 12 月间 35406 例甲状腺 FNAC 标本（11438 例 CS 和 23968 例 SurePath），以手术病理诊断为金标准。

结果

CS 和 SurePath 的 TBSRTC 细胞学分类分布相当。CS 的非诊断/不满意比例高于 SurePath（43.4% vs. 22.3%；p < .05）。常规使用 SurePath 后，手术切除率从 12.0%降至 8.6%（p < .05），恶性率从 32.2%增至 41.5%（p < .05）。CS 和 SurePath 的敏感性分别为 71.0%和 82.0%，特异性分别为 99.0%和 97.3%，阳性预测值分别为 97.8%和 96.8%，阴性预测值分别为 85.0%和 84.6%。CS 和 SurePath 的诊断准确率分别为 88.5%和 89.7%。