Lin J D, Huang B Y, Chao T C, Hsueh C
Department of Internal Medicine, Chang Gung Memorial Hospital, Taiwan, R.O.C.
Acta Cytol. 1997 Nov-Dec;41(6):1751-6. doi: 10.1159/000333180.
To assess the role of ultrasonography and fine needle aspiration cytology (FNAC) in preoperative diagnosis of patients with occult thyroid carcinoma (OTC).
Data on 768 thyroid carcinoma patients receiving primary treatment at Chang Gung Medical Center were retrospectively reviewed. Of these patients, 97 had OTC. To detect small thyroid nodules early and define the characteristics of clinically palpable nodules, thyroid ultrasonography with FNAC were performed on 67 histopathologically proven OTC patients. Analysis for diagnostic value was done for ultrasonography and FNAC.
In the 67 patients receiving ultrasonography with FNAC, 23 were preoperatively diagnosed as having papillary thyroid carcinoma and 1 as having follicular carcinoma. The tumor size of these 24 preoperative FNAC-proven OTC was 0.81 +/- 0.23 cm (mean +/- SD). In the remaining patients, 10 presented pictures suspicious for malignancy, with a mean tumor size 0.63 +/- 0.24 cm, and 33 (49.3%) were diagnosed as having benign thyroid lesions in preoperative FNAC. The tumor size in these 33 lesions was 0.58 +/- 0.24 cm. Fifty-seven of the 67 OTC patients received frozen sections. Thirty-eight papillary thyroid carcinomas and four follicular carcinomas were correctly diagnosed on frozen sections.
Although the rate is not high, high-resolution ultrasonography and FNAC is the best approach to preoperative diagnosis for OTC patients today.
评估超声检查和细针穿刺细胞学检查（FNAC）在隐匿性甲状腺癌（OTC）患者术前诊断中的作用。
回顾性分析了768例在长庚医疗中心接受初次治疗的甲状腺癌患者的数据。其中，97例为OTC患者。为了早期发现甲状腺小结节并明确临床可触及结节的特征，对67例经组织病理学证实的OTC患者进行了甲状腺超声检查及FNAC。对超声检查和FNAC的诊断价值进行了分析。
在67例接受超声检查及FNAC的患者中，23例术前被诊断为乳头状甲状腺癌，1例为滤泡状癌。这24例术前经FNAC证实的OTC患者的肿瘤大小为0.81±0.23 cm（均值±标准差）。其余患者中，10例表现出可疑恶性的图像，平均肿瘤大小为0.63±0.24 cm，33例（49.3%）在术前FNAC中被诊断为良性甲状腺病变。这33个病变的肿瘤大小为0.58±0.24 cm。67例OTC患者中有57例接受了冰冻切片检查。冰冻切片正确诊断出38例乳头状甲状腺癌和4例滤泡状癌。
尽管准确率不高，但高分辨率超声检查和FNAC是目前OTC患者术前诊断的最佳方法。
