超声引导下细针吸取细胞病理学诊断甲状腺乳头状癌的临床研究  

Study of Ultrasound-guided Fine Needle Aspiration for Cellular Pathological Diagnosis of Thyroid Papillary Cancer

作　　者：刘琪 康劲松[2] 马珩 赵雅桐 余静薇 雷清华 Liu Qi;Kang Jinsong;Ma Heng(Department of Oncology,Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Surgery,Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院肿瘤科,武汉430030 [2]华中科技大学同济医学院附属同济医院外科,武汉430030 [3]华中科技大学同济医学院基础医学院人体解剖学系,武汉430030 [4]华中科技大学同济医学院,基础医学国家级实验教学示范中心,武汉430030

出　　处：《华中科技大学学报（医学版）》2024年第5期676-680,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：教育部产学合作协同育人项目(No.220601164153451)。

摘　　要：目的探讨超声引导下细针吸取细胞病理学诊断甲状腺乳头状癌的临床意义。方法针对超声检查直径小于1 cm,临床触诊阴性的甲状腺结节病例,行超声引导下细针吸取细胞病理学检查,并将细胞病理学结果与术后组织病理学结果及BRAF基因V600E突变(BRAF V600E)检测结果进行对比分析。结果511例患者中,细胞病理学结果显示取材失败20例,良性病变14例,可疑恶性230例,甲状腺乳头状癌242例,非霍奇金淋巴瘤2例,甲状腺髓样癌3例;组织病理学结果显示良性病例5例,甲状腺乳头状癌496例,甲状腺乳头状癌合并桥本甲状腺炎3例,非霍奇金淋巴瘤3例,甲状腺髓样癌4例。细胞病理学假阴性病例10例,无假阳性病例,细胞病理学与组织病理学诊断符合率为94.27%。结论超声引导下细针吸取细胞病理学检查对甲状腺乳头状癌具有较高的诊断正确率,可对临床触诊阴性的甲状腺肿块进行较准确的术前诊断,结合术后组织病理学及BRAF V600E检测结果,为后续治疗及随访策略提供指导。Objective To explore the clinical significance of ultrasound-guided fine needle aspiration cytology in the diagnosis of papillary thyroid carcinoma.Methods For cases of thyroid nodules with a diameter less than 1 cm and negative clinical palpation detected by ultrasound,ultrasound-guided fine needle aspiration cytological examination was performed,and the cytological results were compared and analyzed with postoperative histopathological results and BRAFV600E detection results.Results Among the 511 cases,the cytopathological results showed 20 cases of failed sampling,14 cases of benign lesions,230 cases of suspected malignancy,242 cases of papillary thyroid carcinoma,2 cases of non-Hodgkin's lymphoma,and 3 cases of medullary thyroid carcinoma.The histopathological results showed 5 benign cases,496 papillary thyroid carcinoma,3 papillary thyroid carcinoma with Hashimoto's thyroiditis,3 non-Hodgkin's lymphoma,and 4 medullary thyroid carcinoma.There were 10 false negative cases in cellular pathology,with no false positive cases.The consistency rate between cellular pathology and histopathology was 94.27%.Conclusion Ultrasound-guided fine needle aspiration cytology has a high diagnostic accuracy for papillary thyroid carcinoma,and provides accurate results for clinical palpation negative masses before surgery.Combined with postoperative histopathology and BRAFV600E gene testing results,it provides a strategy for subsequent treatment and follow-up.

关 键 词：细针吸取细胞病理学 超声引导 甲状腺乳头状癌 BRAF基因V600E突变 

分 类 号：R736.1[医药卫生—肿瘤]