Osama Md Ali, Bakshi Pooja, Verma Kusum, Yadav Ajit
Department of Pathology, Lady Hardinge Medical College, New Delhi, India.
Department of Cytopathology, Sir Gangaram Hospital, Old Rajinder Nagar, New Delhi, 110060 India.
Indian J Surg Oncol. 2025 Feb;16(1):38-46. doi: 10.1007/s13193-024-02018-5. Epub 2024 Jul 10.
Fine needle aspiration (FNA) is an established technique in evaluation of thyroid nodules. Traditionally, conventional smears (CS) are prepared as an accepted method for cytologic interpretation. However, with the advent and success of liquid-based cytology (LBC) in gynecological and non-gynecological specimens, there has been an increased interest in its application in thyroid FNA as well. Studies evaluating LBC in thyroid aspirates have emerged in recent years and have shown variable results. Patients presenting with complaints of a palpable swelling in the thyroid/midline neck area or with a detectable lesion on ultrasound were subjected to FNA. A split sample technique was used to prepare CS and LBC smears. The cytological diagnosis of CS and LBC was compared with each other and with follow up. The performance of both methods was estimated in terms of sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy. The specificity, positive and negative predictive value, and accuracy of LBC were comparable to CS. The sensitivity of LBC was slightly lower than CS. The diagnostic accuracy of LBC was comparable to CS demonstrating its utility in thyroid FNAs. LBC offers the advantages of lesser screening time, decreased obscuration by blood, decreased artefactual changes, and potential for adjunctive immunocytochemistry/molecular testing. However, due to a higher unsatisfactory rate in benign lesions, LBC may be used as a supplement to CS in thyroid FNAs.
细针穿刺抽吸术（FNA）是评估甲状腺结节的一项成熟技术。传统上，制备常规涂片（CS）是一种被认可的细胞学诊断方法。然而，随着液基细胞学（LBC）在妇科和非妇科标本中的出现及成功应用，人们对其在甲状腺FNA中的应用也越来越感兴趣。近年来出现了一些评估甲状腺抽吸物中LBC的研究，结果各不相同。对出现甲状腺/颈部中线区域可触及肿块或超声检查发现可检测病变的患者进行FNA。采用分割样本技术制备CS和LBC涂片。将CS和LBC的细胞学诊断结果相互比较，并与随访结果进行比较。从敏感性、特异性、阳性预测值、阴性预测值和诊断准确性方面评估两种方法的性能。LBC的特异性、阳性和阴性预测值以及准确性与CS相当。LBC的敏感性略低于CS。LBC的诊断准确性与CS相当，表明其在甲状腺FNA中的实用性。LBC具有筛查时间短、血液造成的模糊度降低、人为改变减少以及可进行辅助免疫细胞化学/分子检测的潜力等优点。然而，由于良性病变的不满意率较高，LBC可作为甲状腺FNA中CS的补充方法。
