Anesthesiology Department, Skellefteå Hospital, Skellefteå, Sweden.
Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, 70185, Sweden.
Sci Rep. 2024 Oct 16;14(1):24216. doi: 10.1038/s41598-024-75677-7.
Introduction Fine-needle aspiration cytology (FNAC) is an effective tool in the diagnostic work-up of patients with thyroid nodules. The aim of our study was to assess the diagnostic sensitivity of FNAC in thyroid cancer (TC) in Sweden by correlating the findings of preoperative FNAC with those obtained through final histology of the surgical specimen. Methods A Swedish nationwide cohort of patients having surgery for TC (n = 2519) from the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal surgery between 2004 and 2013 was obtained. Data was validated through scrutinizing patient FNAC and histology reports. Results Among the 2519 cases operated with a final diagnosis of TC, the diagnosis was substantiated and validated through the histology report in 2332 cases (92.6%), included in the present study. Among these, 1679 patients (72%) were female and the median age at TC diagnosis was 52.3 years (range 18-94.6). In 353 cases (15.1%) FNAC was not performed at all; whereas in the remaining 1965 cases, the diagnostic sensitivity of FNAC was 81.6%. In lesions > 1 cm, FNAC diagnostic sensitivity reached 86.5%, whereas in lesions < 1 cm, FNAC yielded a sensitivity of 61.5%. Approximately 85% of FNACs (n = 1981/2332) were performed using ultra-sonographic (US) guidance. In TC lesions > 1 cm, the diagnostic sensitivity of US-guided FNAC (n = 1504) was 86.9% as compared to 76.9% in clinically applied FNAC without US utilization (n = 118). Conclusions FNAC is performed in most patients operated for TC in Sweden (85%) and retains its value as a tool in TC diagnostic work-up with an overall sensitivity of 82%, reaching 87% in lesions > 1 cm, that harbor clinically relevant TC.
介绍
细针穿刺细胞学检查（FNAC）是甲状腺结节诊断工作中的有效工具。我们的研究目的是通过将术前 FNAC 结果与手术标本的最终组织学结果进行比较，来评估 FNAC 在瑞典甲状腺癌（TC）诊断中的敏感性。
方法
我们获得了 2004 年至 2013 年间斯堪的纳维亚甲状腺、甲状旁腺和肾上腺手术质量登记处进行 TC 手术的 2519 例患者的全国性队列。通过仔细检查患者的 FNAC 和组织学报告来验证数据。
结果
在 2519 例最终诊断为 TC 的手术病例中，有 2332 例（92.6%）通过组织学报告证实和验证了诊断，包括在本研究中。其中，1679 例（72%）为女性，TC 诊断时的中位年龄为 52.3 岁（18-94.6 岁）。在 353 例（15.1%）病例中根本没有进行 FNAC；而在其余 1965 例病例中，FNAC 的诊断敏感性为 81.6%。在病灶>1cm 的情况下，FNAC 的诊断敏感性达到 86.5%，而在病灶<1cm 的情况下，FNAC 的敏感性为 61.5%。大约 85%的 FNAC（n=1981/2332）是在超声（US）引导下进行的。在病灶>1cm 的 TC 病变中，US 引导下 FNAC 的诊断敏感性（n=1504）为 86.9%，而临床应用无 US 辅助的 FNAC（n=118）的敏感性为 76.9%。
结论
FNAC 在瑞典 TC 手术患者中（85%）普遍应用，并且作为 TC 诊断工作中的工具仍具有价值，其总体敏感性为 82%，在病灶>1cm 的情况下敏感性达到 87%，这些病灶中包含具有临床意义的 TC。
