Gimondo P, Messina G, Caratozzolo M, Tomei A
III Divisione di Medicina, Ospedale S. Giovanni, USL RM/4, Roma.
Radiol Med. 1994 May;87(5):648-52.
FNAB cytology is a very specific diagnostic tool for distinguishing benign from malignant lesions. It allows the histologic type to be diagnosed too. FNAB findings also help select the type of surgery. The value of FNAB cytology was investigated in 5,109 patients examined from 1987 through March 1993. 607 patients has surgical confirmation. 444 patients underwent cytology before surgery, while 163 patients were not submitted to FNAB. Histology diagnosed 116 malignant tumors (19.2%): 83 of them were papillary carcinomas (71.5%), 26 follicular carcinomas (2.6%), 1 primary thyroid lymphoma (0.9%) and 3 medullary carcinoma (2.6%). Seventy-nine of 116 cases had been diagnosed by FNAB cytology, while 37 of 116 were diagnosed at surgery. Aspiration biopsy under US guidance reduced the rate of thyroidectomies from 19.2% to 8.5% because true-positive cases were assessed before surgery. FNAB cytology should be used as a preliminary diagnostic tool, thanks to its high accuracy and to its capabilities of distinguishing benign from malignant lesions for proper medical or surgical treatment. Moreover, FNAB cytology allows potentially malignant lesions to be surgically explored.
细针穿刺抽吸活检（FNAB）细胞学检查是区分良性与恶性病变的一种非常特异的诊断工具。它还能诊断组织学类型。FNAB检查结果也有助于选择手术类型。对1987年至1993年3月期间接受检查的5109例患者的FNAB细胞学检查价值进行了研究。607例患者获得手术证实。444例患者在手术前行细胞学检查，而163例患者未接受FNAB检查。组织学诊断出116例恶性肿瘤（19.2%）：其中83例为乳头状癌（71.5%），26例为滤泡状癌（2.6%），1例原发性甲状腺淋巴瘤（0.9%），3例髓样癌（2.6%）。116例病例中有79例通过FNAB细胞学检查确诊，而116例中有37例在手术时确诊。超声引导下的穿刺活检将甲状腺切除术的比例从19.2%降至8.5%，因为在手术前对真阳性病例进行了评估。由于FNAB细胞学检查具有高准确性以及区分良性与恶性病变的能力，可用于恰当的药物或手术治疗，因此应将其用作初步诊断工具。此外，FNAB细胞学检查可对潜在的恶性病变进行手术探查。
