甲状腺结节细针穿刺检查782例临床病理分析

Fine-needle aspiration biopsy for thyroid nodules： a clinical and pathological study of 782 patients

目的分析甲状腺结节细针穿刺（FNAB）检查的诊断结果及其应用价值。方法回顾性分析782例行FNAB检查患者的临床病理资料。细胞病理诊断分为6类，为未诊断、良性病变、滤泡性病变、滤泡性肿瘤、可疑恶性和恶性。对其中手术治疗的76例患者的组织病理与细胞病理进行对比，判断细针穿刺的准确性。结果782例行FNAB检查患者中，良性病变占74．4％（582／782），恶性诊断只占2．6％（20／782），滤泡性肿瘤占5．6％（44／782），滤泡性病变、可疑恶性分别为3。2％（25／782）和2．9％（23／782），未诊断者占11．3％（88／782）。76例手术患者中，组织病理诊断良性疾病占65．8％（50／76），恶性肿瘤占28．9％（22／76），良性肿瘤占5．3％（4／76）。在细胞病理诊断为良性和恶性两大类中，与组织病理的符合率较高，分别为16／16和16／17。结论甲状腺细针穿刺是甲状腺结节诊断和鉴别诊断的可靠方法。

Objective To evaluate clinical application of thyroid fine-needle aspiration biopsy （ FNAB ） and its diagnostic value. Methods FNAB was performed for 782 cases during 2005 - 2009 at China-Japan Friendship Hospital, Beijing and their clinical pathological data were retrospectively analyzed. Cytopathological diagnoses by FNAB were classified as unsatisfactory, benign, atypical cellular lesions, follicular neoplasm, suspicious malignancy and definite malignancy. Results of thyroid cytological and histological examinations of 76 patients with subsequent thyroidectomies were compared to those with FNAB to evaluate its diagnostic accuracy. Results Of 782 FNAB specimens, 74.4 % （582/782） were classified as benign, 2.6 % （20/782） as malignant, 5.6 % （44/782） as follicular neoplasm, 3.2 % （25/782） as atypical cellular lesion, 2.9% （23/782） as suspicious malignancy and 11.3 % （88/782） as unsatisfactory,. Among 76 patients with thyroideetomies, 65.8 % of them （50/76） were histologically diagnosed as benign lesion, 28.9 % （22/76） as definite malignancy and only 5.3 % （4/76） as benign follicular adenoma. Agreement between FNAB cytological diagnoses and histologically confirmed diagnoses for benign lesion and malignancy was 16/16 and 16/17, respectively. Conclusion FNAB is a reliable diagnostic method for evaluation of thyroid nodules.