细针穿刺细胞学联合血清降钙素对甲状腺髓样癌的诊断价值

Diagnostic value of fine needle aspiration cytology combined with serum calcitonin for medullary thyroid carcinoma

目的探讨细针穿刺细胞学联合血清降钙素对甲状腺髓样癌的诊断价值。方法回顾性分析经手术病理证实的17例甲状腺髓样癌的血清降钙素及细针穿刺结果,比较两种方法单独及联合对甲状腺髓样癌的诊断价值。结果 17例甲状腺髓样癌患者中13例(13/17,76.5%)术前行细针抽吸活检,11例(11/13,84.6%)诊断为甲状腺恶性肿瘤,其中7例确诊或可疑髓样癌(7/13,53.8%)。16例血清降钙素不同程度升高(16/17,94.1%)。细针穿刺细胞学联合血清降钙素检测诊断甲状腺髓样癌的灵敏度为92.3%(12/13)。结论细针穿刺细胞学是评估甲状腺结节良恶性的重要诊断工具,但对甲状腺髓样癌的诊断灵敏度不高,血清降钙素灵敏度高但临床无法全面普及;与单独细针穿刺细胞学相比,细针穿刺联合血清降钙素检测可明显提高术前甲状腺髓样癌的检出率,减少漏诊。

Objective To investigate the value of fine-needle aspiration cytology (FNAC) combined with serum calcitonin in the diagnosis of medullary thyroid carcinoma (MTC).Methods Retrospective analysis of the serum calcitonin and FANC results in 17 cases of MTC confirmed by pathological examination.The diagnostic value of the two methods alone and in combination for MTC were compared.Results 13 of the 17 MTC patients (13/17,76.5%) underwent fine needle aspiration biopsy before surgery,11 cases (11/13,84.6%) diagnosed as thyroid malignant tumor,7 of whom were diagnosed or suspected of MTC (7/13,53.8%).Serum calcitonin levels increased in different degrees in 16 patients.The sensitivity of the two methods combined in the diagnosis of MTC was 92.3%(12/13).Conclusions FNAC is an important diagnostic method for the evaluation of thyroid nodules,but it is not sensitive to the diagnosis of MTC.Serum calcitonin is highly sensitive but not universally available.Compared with FNAC alone,FNAC combined with the serum calcitonin examination may significantly improve the detection rate of MTC preoperative and reduce missed diagnosis.