细胞学检查在≥4cm甲状腺结节中的假阴性率研究  

Investigation of false-negative rate of cytology in thyroid nodules≥4 cm

作　　者：叶栋[1] 沈志森[1] 沈晓涵[2] 裘世杰[1] 邬振华[1] 丁华新[2] 汪春年[2] 

机构地区：[1]宁波市医疗中心李惠利医院耳鼻咽喉头颈外科,浙江宁波315040 [2]宁波市医疗中心李惠利医院病理科,浙江宁波315040

出　　处：《中国耳鼻咽喉头颈外科》2011年第6期288-290,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的通过比较甲状腺结节(≥4 cm)穿刺后细胞学检查与术后组织病理学检查结果,探讨细针穿刺细胞学(fine-needle aspiration cytology,FNAC)方法检查甲状腺结节(≥4 cm)中的假阴性率,进而指导临床诊断、治疗。方法选择符合条件甲状腺结节(≥4 cm)患者,先后予FNAC检查及手术切除结节行组织病理学检查,比较分析检查结果。结果符合条件的143例患者组织学证实21%为恶性,排除细胞学检查标本不足病例,26例肿瘤中有3例细胞学检查显示为良性(敏感性为88.5%),细胞学检查不能确定性质病例(滤泡性肿瘤)29.4%为恶性,其中80%为乳头状癌。细胞学检查为阴性的诊断符合率为96.2%,假阴性率仅为3.8%。结论在甲状腺结节(≥4 cm)患者中,FNAC对结节良、恶性诊断价值较高,与组织病理学检查诊断符合率较好,为诊断甲状腺结节性质的很有价值方法。OBJECTIVE To compare the results of cytology and histology obtained for thyroid nodules ≥4 cm,and to investigate the false-negative rate of cytology in thyroid nodules≥4 cm.METHODS A group of patients with thyroid nodules≥4 cm was submitted to fine needle aspiration cytology and histopathological examination.RESULTS Malignancy was confirmed histologically in 21% of the patients.Excluding cases of insufficient material,cytology was benign in only 3/26 patients with carcinomas（88.5% sensitivity）.The frequency of malignancy was 29.4% among nodules with indeterminate cytology（follicular neoplasm）,and there FNAC is high,and most of thyroid nodules≥4 cm have was a predominance（80%）of papillary carcinoma.The negative predictive value of benign cytology was 96.2%.The false-negative rate of cytology in thyroid nodules≥ 4 cm was 3.8%.CONCLUSION The diagnostic value of high total diagnostic accordance rate.FNAC is a valuable method to the diagnosis of thyroid nodules≥4 cm.

关 键 词：甲状腺结节 活组织检查 细针 细胞学技术 诊断 组织病理学 

分 类 号：R581[医药卫生—内分泌]