Lin J D, Huang B Y, Weng H F, Jeng L B, Hsueh C
Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan Hsien, Taiwan, ROC.
J Clin Ultrasound. 1997 Mar-Apr;25(3):111-8. doi: 10.1002/(sici)1097-0096(199703)25:3<111::aid-jcu3>3.0.co;2-j.
This series retrospectively reviewed 3657 patients who received thyroid ultrasonography with fine-needle aspiration cytological (FNAC) examinations at Chang Gung Memorial Hospital during the period from January 1, 1993 to December 31, 1993. Thyroid ultrasonography studies were performed using a real-time ultrasonographic machine with a 10 MHz transducer. The aspirates were air dried and stained by the Romanowsky-based Liu method. Three hundred seventy-eight cases (10.3%) received surgical treatment after the ultrasonographic and FNAC examinations. Benign lesions were diagnosed in 269 patients. Thyroid malignancy was confirmed histopathologically in 109 cases including 76 papillary thyroid carcinomas, 17 follicular carcinomas, 5 medullary thyroid carcinomas, 3 anaplastic carcinomas, 3 Hürthle cell carcinomas, and 3 lymphomas. Another 2 cases were metastatic cancer to thyroid. The results demonstrated that 28.8% of the surgically treated patients had histopathologically proven malignancies. The incidence of thyroid malignancy was 2.98% in this study. The sensitivity of the cytological diagnosis was 79.80% and the specificity was 98.66%. The positive predictive value was 96.34%. Negative predictive value was 91.70%. The false negative index was 20.20%. The diagnostic accuracy was 92.89%. Thyroid ultrasonography with the FNAC can provide high specificity and sensitivity in differentiating malignant lesions from benign.
本研究回顾性分析了1993年1月1日至1993年12月31日期间在长庚纪念医院接受甲状腺超声检查及细针穿刺细胞学检查（FNAC）的3657例患者。甲状腺超声检查使用配备10MHz探头的实时超声诊断仪。穿刺样本经空气干燥后，采用基于罗曼诺夫斯基法的刘氏染色法染色。378例（10.3%）患者在超声及FNAC检查后接受了手术治疗。269例患者被诊断为良性病变。经组织病理学证实109例为甲状腺恶性肿瘤，其中包括76例乳头状甲状腺癌、17例滤泡状癌、5例髓样癌、3例未分化癌、3例许特莱细胞癌和3例淋巴瘤。另外2例为甲状腺转移癌。结果显示，手术治疗的患者中28.8%经组织病理学证实为恶性肿瘤。本研究中甲状腺恶性肿瘤的发生率为2.98%。细胞学诊断的敏感性为79.80%，特异性为98.66%。阳性预测值为96.34%。阴性预测值为91.70%。假阴性率为20.20%。诊断准确率为92.89%。甲状腺超声联合FNAC在鉴别恶性病变与良性病变方面具有较高的特异性和敏感性。
