Miller J M, Kini S R, Hamburger J I
Cancer. 1985 Jun 15;55(12):2812-7. doi: 10.1002/1097-0142(19850615)55:12<2812::aid-cncr2820551216>3.0.co;2-n.
To test the value of needle biopsy for a diagnosis of follicular thyroid malignancy, we compared needle biopsy and surgical diagnoses for 1005 patients. There were 67 follicular carcinomas, 34 Hurthle cell carcinomas, and 39 follicular variants of papillary carcinoma. Malignancy was diagnosed or suspected by biopsy for 114 of the cancers (82%), considered "possible" for 24 (17%), and misdiagnosed as "benign" in 2. Sensitivity of fine-needle biopsy (FNB) for the diagnosis of 39 cancers approximated that of large-needle biopsy (LNB) for 101 cancers 2 cm or larger. Diagnostic specificity for cancer varied with the degree of cytologic or histologic abnormality. Specificity of FNB was comparable to LNB on nodules large enough for both procedures. Specificity of FNB on nodules too small for LNB was substantially less. The sensitivity of needle biopsy allows selection of many follicular nodules for observation. Knowledge of the probability of cancer for each cytologic or histologic diagnosis is useful in determination of the need for thyroid surgery.
为了测试针吸活检对诊断滤泡性甲状腺恶性肿瘤的价值，我们比较了1005例患者的针吸活检和手术诊断结果。其中有67例滤泡癌、34例许特耳细胞癌和39例乳头状癌的滤泡变体。114例癌症（82%）通过活检诊断或怀疑为恶性，24例（17%）被认为“可能”，2例被误诊为“良性”。细针穿刺活检（FNB）对39例癌症的诊断敏感性与粗针穿刺活检（LNB）对101例直径2厘米或更大癌症的诊断敏感性相近。癌症的诊断特异性随细胞学或组织学异常程度而异。对于足够大到两种方法都适用的结节，FNB的特异性与LNB相当。对于太小而无法进行LNB的结节，FNB的特异性明显较低。针吸活检的敏感性有助于选择许多滤泡性结节进行观察。了解每种细胞学或组织学诊断的癌症概率，对于确定是否需要进行甲状腺手术很有用。
