甲状腺结节细针穿刺细胞学检查的诊断价值  

Clinic value of fine needle aspiration cytology in the diagnosis of thyroid nodule

作　　者：林振中[1] 刘东利[1] 王惠萍[1] 许里[1] 

机构地区：[1]江苏省肿瘤医院门诊细胞室,江苏南京210009

出　　处：《中国肿瘤外科杂志》2015年第4期235-237,252,共4页Chinese Journal of Surgical Oncology

摘　　要：目的分析甲状腺结节细针穿刺细胞学检查(fine-needle aspiration biopsy,FNAB)的应用价值。方法回顾性分析578例行FNAB检查患者的临床病理资料。应用Bethesda报告系统诊断分类,对其中手术治疗的132例患者的组织病理与细胞病理进行对照。结果 132例患者的FNAB检查结果应用Bethesda报告系统诊断分类,将标本分为6类,分别是:标本无法诊断占7.6%;良性病变占43.2%;意义不明确的细胞非典型病变占19.7%;滤泡性肿瘤及可疑滤泡性肿瘤占5.3%;可疑恶性肿瘤占6.8%;恶性肿瘤占17.4%。将FNAB检查结果与组织病理对照后发现:甲状腺结节细针穿刺判断甲状腺良恶性结节的灵敏度及特异度分别为81.1%和97.6%,阳性预测值为93.8%。结论甲状腺细针穿刺对于鉴别甲状腺良恶性结节是可靠的方法。Objective To study the clinical value of fine-needle aspiration cytology of thyroid nodule. Methods A retrospective review was performed among 578 consecutive cases of FNA cytology of thyroid nodules. Cytologic diagnoses were classified as non-diagnostic or unsatisfactory, benign, atypia of unknown significance/follicular lesion of unknown significance（AUS/FLUS） , suspicious for follicular neoplasm（SFN） , suspicious for malignancy and malignancy based on the Bethesda system. The discrepancies between initial cytologic diagnoses and histologic diagnoses were evaluated among 132 surgical specimens. Results Among 132 cases who underwent surgery, FNAs were 7.6% unsatisfactory, 43.2% benign, 19.7% AUS/FLUS, 5.3% SFN, 6.8% suspicious, and 17.4% malignant. The sensitivity, specificity and positive predictive value of thyroid FNA for the diagnosis of malignancy were 81.1% ,97.6% and 93.8% respectively. Conclusions Fine-needle aspiration is a reliable method for identifying benign and malignant thyroid nodules.

关 键 词：甲状腺结节 细针穿刺细胞学检查 诊断 

分 类 号：R581[医药卫生—内分泌] R446.8[医药卫生—内科学]