青少年自身免疫性甲状腺疾病的穿刺细胞学诊断

Cytological diagnosis of auto immune thyroid disease in adolescent

目的 采用甲状腺细针抽吸细胞学检查 (FNAC) ,旨在早期发现青少年免疫性甲状腺疾病 (AITD) ,并为治疗提供帮助。方法 回顾性分析门诊 71例行甲状腺FNAC年龄低于 2 3岁临床上有甲状腺肿大病例的涂片 ,采用HE染色和快速染色法相结合 ,并根据炎症程度依次分成 4型。同时与甲状腺B超检查 ,实验室甲状腺功能状态检查和自身抗体测定相比较。结果 B超显示 :甲状腺机能亢进 (甲亢 ) 12例 ,炎症改变 5 3例 ,腺瘤结节样改变 5例 ,腺体正常 1例 ;甲状腺功能检查T3、T4、FT3、FT4高于正常 2 2例 ,低于正常 9例 ,正常范围 40例。自身抗体抗甲状腺球旦白抗体 (TGAB) ,抗甲状腺微粒体抗体 (TMAB) 70例高于正常 ,1例正常 ;抗甲状腺过氧化物酶抗体 (TPO) 37例高于正常。FNAC示甲亢的病例 14例 ,桥本氏病Ⅰ型 35例 ,Ⅱ型 13例 ,Ⅲ型 3例 ,Ⅳ型桥本氏甲亢 6例。结论 甲状腺FNAC由于安全、简便、快速及准确 ,有利于早期诊断青少年AITD 。

ObjectiveTo assess fine needle aspiration (FNAC) in the early diagnosis for auto immune thyroid disease (AITD) in adolescent.Methods Seventy-one patients, age ranging from 9 to 23 years with thyroid enlargement underwent FNAC. Their smears were classified into 4 types according to the degree of degeneration of adenoidal cell and lymphocyte invasion by HE combining with rapid staining.The results were compared with B ultrasound and serum thyroid auto antibody measurement.ResultsB ultrasound showed hyperthyroidism in 12 cases, inflammation in 53, nodule change in 5, normal in 5. Thyroid function examination demonstrated hyperthyroidism in 22 cases, hypothyroidism in 9 cases, and euthyroidism in 40 cases. Auto thyroid antibody (TGAb,TMAb) were all beyond normal range except in 1 case, and TPOAb elevated in 37 cases. FNAC identified Grave′s disease in 14, Hashimoto′s diseases typeⅠ( HT-Ⅰ) in 35 cases,HT(Ⅱ) in 13,HT(Ⅲ) in 3, and HT(Ⅳ) in 6 cases. ConclusionsFNAC contributes to early diagnosis of AITD in adolescent for its safety, simplicity, rapidity and accuracy.