液基细胞学技术在甲状腺微小结节性病变诊断中的应用价值

Significance of liquid-based cytology test for the diagnosis of thyroid micronodular lesions

目的:探讨病理液基细胞学技术(liquid-based cytology test,LCT)在甲状腺微小结节性病变诊断中的应用价值。方法:对119例甲状腺微小结节性病变进行超声引导下细针穿刺LCT检查,汇总其LCT检查结果,并与手术后组织病理学结果进行对照,对LCT特点及诊断效果进行深入分析。结果:119例甲状腺微小结节性病变LCT结果如下:标本无法诊断11例(9.24%);良性病变4 1例(3 4. 4 5%);意义不明确的细胞非典型病变1 0例(8. 4 0%);滤泡性肿瘤或可疑滤泡性肿瘤4例(3.36%);可疑恶性肿瘤29例(24.37%);恶性肿瘤24例(20.17%)。119例甲状腺微小结节性病变中,58例接受手术治疗,并获得组织病理学诊断结果,以此为金标准,计算得出LCT的诊断灵敏度为95.74%,特异度为63.64%,阳性预测值为92.84%,阴性预测值为77.78%。结论:对于甲状腺微小结节性病变的诊断,从影像学到病理学均存在困难,LCT技术可以显著提高其诊断的准确性,可对绝大部分甲状腺微小结节性病变进行术前精确诊断,有广泛的临床应用价值。

Objective: To explore the significance of liquid-based cytology test (LCT) for the diagnosis of thyroid micronodular lesions. Methods: LCT with ultrasound-guided fine needle aspiration was performed on 119 patients with thyroid micronodular lesions;the LCT results were summarized and compared with the postoperative histopathological results to probe into the liquid-based pathological characteristics and the diagnostic efficacy of LCT. Results: LCT results on the 119 patients with thyroid micronodular lesions: specimens cannot be diagnosed in 11 (9.24%) patients;benign in 41 (34.45%) patients;atypia of undetermined significance in 10 (8.4%) patients;follicular neoplasm or suspicious for a follicular neoplasm in 4 (3.36%) patients;suspicious for malignancy in 29 (24.37%) patients;and malignancy in 24 (20.17%) patients. Among the 119 patients with thyroid micronodular lesions, 59 received surgical treatment and obtained histological diagnostic results, using which as the gold standard the diagnostic sensitivity of LCT was calculated at 95.74%, the specificity at 63.64%, the positive predictive value at 92.84%, and the negative predictive value at 77.78%. Conclusion: Given the difficulties in both imaging and pathological diagnosis of thyroid micronodular lesions, LCT could significantly improve the diagnostic accuracy, allowing accurate preoperative diagnosis of most of the lesions, which supports its extensive clinical application.