针吸穿刺细胞病理学在甲状腺疾病检验中的应用体会

Experience in fine needle aspiration cytological examination in thyroid disease

目的将传统细针穿刺法与"友谊式细针穿刺器"穿刺法在诊断甲状腺肿块中的价值进行比较,以期为临床诊断甲状腺疾病提供有力的诊断依据。方法使用徒手操作注射器负压针吸标本采集法及友谊式细针穿刺器负压针吸标本采集法,并且使用瑞氏染色法与H-E染色法进行涂片染色。就组织结构和细胞形态进行比较。结果243例甲状腺病例中,其中乔本甲状腺炎127例,占甲状腺疾病的52.3%;甲状腺良性肿瘤45例,占甲状腺疾病的18.5%;甲状腺癌6例,占甲状腺疾病2.5%;亚甲炎15例,占甲状腺疾病的6.2%;结节性甲状腺肿为27例,占甲状腺疾病的11.1%;许特莱细胞瘤1例。其中注射器负压针吸标本采集法采集标本141例,友谊式细针穿刺器负压针吸标本采集法采集标本102例。在甲状腺腺瘤、结节性甲状腺肿和甲状腺囊性变病例,友谊式细针穿刺器负压针吸标本采集法准确率分别为98.8%、91.7%和92.3%。在桥本甲状腺炎、亚甲炎病例,徒手操作注射器负压针吸标本采集法准确率分别为92.6%、90.9%。在甲状腺癌病例,两种方法准确率相同。结论临床上在根据触感及其它辅助诊断考虑有甲状腺炎性改变倾向时,建议使用徒手操作注射器负压针吸标本采集法;而当考虑有肿瘤性改变时,推荐使用友谊式细针穿刺器负压针吸标本采集法。

Objective Fine - needle aspiration with traditional method and fine - needle aspiration with friendship - type device puncture were applied in diagnosis of thyroid mass in nature for comparison, and same specimen smears were stained for HE staining and Wright staining, complementary comparison of tissue structure and cell shape was used to increase the positive rate of diagnosis of thyroid diseases. Methods By using needle aspiration method and fine - needle aspiration of friendship - type device method, smears of specimens were stained with Wright staining and HE staining method. Results Among 243 cases of thyroid diseases including 127 cases （52.3%） of Hashimoto＇s thyroiditis, 45 cases （ 18.5 % ） of thyroid benign tumor, 6 cases （2.5 % ） of thyroid cancer, 15 cases （6.2%） of methylene inflammation, 27 cases （ 11.1% ） of nodular goiter and 1 case of Xu Terai cell tumor. Among them, specimens of 141 cases were collected by disposable syringe vacuum specimen collection needle aspiration, and specimens of 102 eases were collected by fine - needle aspiration of friendship - type device aspiration specimen collection method. The accurate rates of fine - needle aspiration of friendship - type device aspiration specimen collection method in thyroid adenoma, nodular goiter and cystic degeneration of thyroid were 98.8%, 91.7% and 92.3% respectively. The accurate rates of manual operation with syringe suction needle aspiration specimen collection method in Hashimoto＇s thyroiditis and methylene inflammation were 92.6% and 90.9% respectively. In cases of thyroid cancer, both methods have the same accuracy. Conclusion According to touch and other auxiliary diagnosis method with thyroid inflammatory change tendency, it is suggested to use bare hand syringe suction needle aspiration specimen collection method, while in specimens with neoplastic changes, it is recommend to use fine - needle aspiration of friendship - type device aspiration specimen collection method.