Al-Sayer H M, Krukowski Z H, Williams V M, Matheson N A
Br Med J (Clin Res Ed). 1985 May 18;290(6480):1490-2. doi: 10.1136/bmj.290.6480.1490.
During 1 September 1981 to August 1982 aspiration cytology was carried out in all isolated thyroid swellings referred to the Aberdeen Thyroid Clinic: cytological findings were not disclosed, did not influence management, and were compared retrospectively with the histological diagnosis. In a total of 70 swellings sensitivity for the detection of neoplasia was 86% and overall accuracy 92%; the positive predictive value was 80% and negative predictive value 96%. During the second year (1 September 1982 to 31 August 1983), when cytological findings were used to influence management, the frequency of operation for isolated thyroid swellings decreased by 25% and the proportion of operations for neoplasia increased from 31% to 50%. In terms of bed occupancy the potentially avoidable surgical workload for benign disease was reduced by 34%. Aspiration cytology, carried out at the first clinic attendance, makes a sound basis for selective surgery and leads to economy in the management of isolated thyroid swellings.
1981年9月1日至1982年8月期间，对所有转诊至阿伯丁甲状腺诊所的孤立性甲状腺肿大患者进行了细针穿刺细胞学检查：细胞学检查结果未公开，不影响治疗管理，并与组织学诊断进行回顾性比较。在总共70例肿大病例中，肿瘤检测的敏感性为86%，总体准确率为92%；阳性预测值为80%，阴性预测值为96%。在第二年（1982年9月1日至1983年8月31日），当细胞学检查结果用于影响治疗管理时，孤立性甲状腺肿大的手术频率下降了25%，肿瘤手术比例从31%增加到50%。就床位占用而言，良性疾病潜在可避免的手术工作量减少了34%。在首次就诊时进行细针穿刺细胞学检查，为选择性手术提供了可靠依据，并节省了孤立性甲状腺肿大的管理成本。
