Mamoon N, Mushtaq S, Muzaffar M, Khan A H
Department of Cytopathology, Army Medical College, Rawalpindi.
J Pak Med Assoc. 1997 Oct;47(10):255-8.
Fine needle aspiration biopsy is now a first line investigation in thyroid disease. The purpose of this study was to evaluate the results of this technique in comparison with routine histopathology. A total of 593 aspirations over a four year period were included. There were 390 (65.7%) solitary nodules, 124 (20.9%) multinodular goiters, 66 (11.1%) diffuse goitres and 13 (2.2%) recurrent post thyroidectomy nodules. Radioisotope scanning in 386 cases showed 325 (84.2%) cold nodules, 54 (14.0%) warm nodules and 7 (1.8%) hot nodules. There were 458 (77.2%) colloid goitres and cysts, 14 cases of thyroiditis (2.2%) and 30 malignancies diagnosed on fine needle aspiration biopsy. In 19 cases (3.2%) a diagnosis of follicular neoplasm and in 29 cases (4.9%) a diagnosis of suspicious aspirate was made. Histological results were available in 176 cases. In 108 cases findings of histology and FNAB were compared with radioisotope scanning. A sensitivity of 92.8% and 42.8%, a specificity of 90.1% and 98.7% and accuracy index of 90.3% and 94.3% was found, when considering suspicious cases alternatively as positives and negatives. Surgery was recommended in all suspicious cases to prevent reduction in sensitivity of the technique. Fine needle aspiration biopsy was found to be a highly effective procedure which can obviate a lot of unnecessary surgery in thyroid lesions.
细针穿刺活检现已成为甲状腺疾病的一线检查方法。本研究的目的是评估该技术与常规组织病理学相比的结果。在四年期间共纳入了593次穿刺。其中有390个（65.7%）孤立性结节、124个（20.9%）多结节性甲状腺肿、66个（11.1%）弥漫性甲状腺肿和13个（2.2%）甲状腺切除术后复发性结节。386例患者的放射性核素扫描显示325个（84.2%）冷结节、54个（14.0%）温结节和7个（1.8%）热结节。细针穿刺活检诊断出458个（77.2%）胶样甲状腺肿和囊肿、14例（2.2%）甲状腺炎以及30例恶性肿瘤。19例（3.2%）诊断为滤泡性肿瘤，29例（4.9%）诊断为可疑穿刺物。176例有组织学结果。108例将组织学和细针穿刺活检结果与放射性核素扫描进行了比较。当将可疑病例分别视为阳性和阴性时，敏感性分别为92.8%和42.8%，特异性分别为90.1%和98.7%，准确性指数分别为90.3%和94.3%。所有可疑病例均建议手术以防止该技术敏感性降低。细针穿刺活检是一种高效的检查方法，可避免许多甲状腺病变的不必要手术。
