Radetić M, Kralj Z, Padovan I
Tumori. 1984 Jun 30;70(3):271-6. doi: 10.1177/030089168407000313.
The cytologic finding was negative in 1841 patients; accurate in 1763 (95.8%). Suspicious cytology proved malignant in 82 of 252 patients (32.5%). Positive cytology was accurate in 88 out of 97 cases (90.7%). In 1942 benign goiters, cytology was accurate in 90.8% of patients, false suspicious in 8.7% and false positive in 0.5%; the highest percentage of misdiagnosis was in adenomas (15.8%) and thyroiditis (19.0). In 248 malignant goiters, cytology was accurate in 35.5% of patients, suspicious in 33.1%, and false negative in 31.4%. False-negative cytology was found in 44% of follicular cancers, 22.2% of papillary and medullary, and 12.9% anaplastic. The most frequent false-negative cytologic diagnosis was the adenomatous goiter. The accuracy of cytology was statistically higher in papillary cancers than in follicular (77.8% vs 56.0%), in undifferentiated tumors than in differentiated (83.7% vs 65.0%), and in adenomatous nontoxic goiters than in adenomas, thyroiditis and toxic goiters (80.3% vs 42.7%), 20.1% and 13.4%). Positive preoperative fine needle aspiration biopsy cytology is a worthwhile and reliable finding; it fails in less than 10% of patients. Negative cytology, however, does not exclude malignancy in thyroid nodes; it is false negative in more than 30% of cancers.
1841例患者的细胞学检查结果为阴性；1763例（95.8%）结果准确。252例患者中，82例（32.5%）可疑细胞学检查结果证实为恶性。97例病例中，88例（90.7%）阳性细胞学检查结果准确。在1942例良性甲状腺肿患者中，90.8%的患者细胞学检查结果准确，8.7%为假可疑，0.5%为假阳性；误诊率最高的是腺瘤（15.8%）和甲状腺炎（19.0%）。在248例恶性甲状腺肿患者中，35.5%的患者细胞学检查结果准确，33.1%为可疑，31.4%为假阴性。44%的滤泡癌、22.2%的乳头状癌和髓样癌以及12.9%的未分化癌出现假阴性细胞学检查结果。最常见的假阴性细胞学诊断是腺瘤性甲状腺肿。乳头状癌的细胞学检查准确性在统计学上高于滤泡癌（77.8%对56.0%），未分化肿瘤高于分化肿瘤（83.7%对65.0%），腺瘤性非毒性甲状腺肿高于腺瘤、甲状腺炎和毒性甲状腺肿（80.3%对42.7%、20.1%和13.4%）。术前细针穿刺活检细胞学检查结果为阳性是一项有价值且可靠的发现；不到10%的患者检查失败。然而，阴性细胞学检查结果不能排除甲状腺结节的恶性病变；超过30%的癌症患者会出现假阴性结果。
