细化甲状腺乳头状癌细针吸取细胞学的形态学诊断标准

Refinement of fine needle aspiration cytological morphologic criteria of papillary thyroid carcinoma

目的验证北京友谊医院(以下简称"我院")病理科制订的细化甲状腺乳头状癌细针吸取细胞学形态学诊断标准的有效性。方法按照Nikiforov、Kini和我院3种甲状腺乳头状癌细胞学诊断标准回顾2015年3月~2016年12月我院组织学诊断为甲状腺乳头状癌的细针吸取细胞学病例,以组织学诊断结果作为金标准,分别计算3种诊断标准的敏感性、特异性。结果共回顾了339例有切除标本作为对照的甲状腺细针吸取细胞学涂片,其中,337例为甲状腺乳头状癌。以确诊作为阳性标准,我院、Nikiforov和Kini的甲状腺乳头状癌细针吸取细胞学诊断标准的敏感性分别为86.9%(219/337)、34.1%(115/337)及65.0%(219/337),特异性均为100%。我院诊断标准的敏感性比Nikiforov标准增加了52.8%,比Kini标准增加了21.9%。结论我院甲状腺乳头状癌的细胞学诊断具有高度特异性和敏感性,具有推广价值。

Objective To validate the efficiency of the cytological diagnostic criterion of papillary thyroid carcinoma （PTC） defined by of Beijing Friendship Hospital （＂BFH＂ for short）. Methods All thyroid fine needle aspiration （FNA） cases with histological resuhs of PTC were reviewed from March 2015 to December 2016 by Nikiforov＇s, Kini＇s and BFH＇s cyto- logical diagnostic eriterias of PTC. The sensitivities and specifieities of 3 eriterias were calculated with histological results as the goht standard. Results Total 339 thyroid FNA cases with histological resuhs as control were reviewed, including 337 cases of PTC. With definite diagnosis as positive standard, the sensitivities of 3 kinds of PFC FNA eytological diagnos- tic criteria was 86.9% （219/337）, 34.1% （115/337） and 65.0% （219/337）, respectively. The speeificities were all 100%. The sensitivity of BFH criterion increased 52.8% and 21.9% compared with Nikifprov and Kini criterion. Conclusion The BFH＇s PTC cytologic diagnostic eriterion has highly sensitive, specific and worthy of the recommendation.