细针穿刺细胞学检查在弥漫硬化型甲状腺乳头状癌中的诊断价值  

Value of fine needle aspiration cytology in diagnostic of diffuse sclerosing variant of papillary thyroid carcinoma

作　　者：何润东 付庆锋[1] 孙平 张帅[1] 孙辉[1] 周乐[1] HE Rundong;FU Qingfeng;SUN Ping;ZHANG Shuai;SUN Hui;ZHOU Le(Department of Thyroid Surgery,China-japan Union Hospital of Jilin University,Jilin Provincial Key Laboratory of Translational Medicine of Surgery,Jilin Provincial Engineering Laboratory of Thyroid Disease Prevention and Treatment,Changchun 130033,China)

机构地区：[1]吉林大学中日联谊医院甲状腺外科,吉林省外科转化医学重点实验室,吉林省甲状腺疾病防治工程实验室,吉林长春130033

出　　处：《中国实验诊断学》2025年第1期12-15,共4页Chinese Journal of Laboratory Diagnosis

基　　金：吉林省财政厅项目(2019SCZ029)。

摘　　要：目的探讨超声引导下细针穿刺细胞学检查(fine needle aspiration cytology FNAC)在弥漫硬化型甲状腺乳头状癌(Diffuse sclerosing variant of papillary thyroid carcinoma DSVPTC)诊断与鉴别诊断中的价值。方法回顾性分析吉林大学中日联谊医院甲状腺外科2015年1月至2022年9月23例DSVPTC患者的一般资料、超声、穿刺细胞学及石蜡病理结果。结果23例均行FNAC检查,单侧取材18例,双侧取材5例,共28个穿刺标本;其中25个穿刺标本经术后病理证实为DSVPTC,术前甲状腺FNAC诊断为乳头状癌20个(20/25),可疑癌4个(4/25),另有一例提示为意义不明的非典型病变,因可疑淋巴结FNAC诊断为转移性PTC行手术治疗而证实。另外,术前对20例患者同时行可疑淋巴结FNAC检查,其中13例确诊为转移性PTC并均经术后病理证实。结论通过对DSVPTC患者甲状腺病灶及可疑淋巴结行FNAC检查,有助于DSVPTC的诊断与鉴别,为临床个体化精准治疗提供依据。Objective To investigate the value of ultrasound-guided fine needle aspiration cytology(FNAC)in the diagnosis and differential diagnosis of diffuse sclerosing variant of papillary thyroid carcinoma(DSVPTC).Methods A retrospective analysis was conducted on 23patients with DSVPTC diagnosed at Department of Thyroid Surgery,China-Japan Union Hospital of Jilin University from January 2015to September 2022.The study encompassed general patient information,ultrasound findings,fine-needle aspiration cytology and paraffin pathology results.Relevant literature was also reviewed.Results 23patients underwent FNAC examination,including 18cases of unilateral sampling and 5cases of bilateral sampling,with a total of 28biopsy specimens.Among them,25specimens were confirmed as DSVPTC by postoperative pathology,20specimens(20/25)were diagnosed as papillary carcinoma by preoperative thyroid FNAC,4 specimens(4/25)were suspected of carcinoma,and one specimen have unclear cell atypical lesion.Suspevted cervical lymph wde FNAC in sapport of motastatic thgroid cancerwas sargically confirmed.In addition,20patients underwent preoperative FNAC examination of suspicious lymph nodes,and 13of them were diagnosed as metastatic PTC and confirmed by postoperative pathology.Conclusion FNAC examination of thyroid lesions and suspicious lymph nodes in patients with DSVPTC is helpful for the diagnosis and differential diagnosis of DSVPTC,and provides a basis for clinical individualized precision treatment.

关 键 词：甲状腺乳头状癌 弥漫硬化型 细针穿刺细胞学 

分 类 号：R736.1[医药卫生—肿瘤]