甲状腺穿刺活检临床研究

Study on clinical significance of thyroid biopsies in thyroid disease

目的探讨穿刺活检在甲状腺疾病诊断中的临床意义。方法对52例难于诊断的甲状腺疾病患者给予甲状腺细针抽吸细胞学检查(FNAB)和粗针穿刺活检(CNB)。结果CNB穿刺成功率100.0%,病理诊断率100.0%,FNAB敏感性:71.4%,特异性95.2%,FNAB结果与组织病理诊断符合率82.7%,16.7%以上桥本氏甲状腺炎患者甲状腺球蛋白抗体(TgAb),甲状腺微粒体抗体(TMAb)测定结果阴性。结论甲状腺疾病诊断中,当FNAB结果不肯定,有必要联合应用CNB,CNB是一种全面诊断甲状腺疾病简便、安全可靠的方法。

[ Objective ] To investigate the clinical significance of thyroid biopsies in the diagnosis of thyroid diseases. [Methods] 52 uncertain diagnosis thyroid disease patients who were treated fine needle aspiration biopsy （FNAB） and coarse needle biopsy （CNB） of thyroid, cytologic and histologic diagnosis were compared in all patients. [Results] Of 52 CNB cases, all biopsies were successfully performed with Tru-Cut bioptic needle, 52 sammples （100%） were adequate for histologic diagnosis. The sensitivity of FNAB was 71.4% and the specificity was 95.2%, the accuracy of FNAB diagnosis was 80.8% contrasted to histopathology. In more than 16.74 the circulating autoantibodies TgAb and TMAb were negative with histologically diagnosed hashimoto＇s thyroiditis. [Conclusion] Analysis of the results indicates that CNB is necessary for patients with atypical thyroid disease, when the FNAB result in uncertain, CNB is a simple, safe, reliable and overall diagnosis method in thyroid diseases.