74例甲状腺结节的细胞学与组织病理学的对比研究.doc

74例甲状腺结节的细胞学与组织病理学的对比研究
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作者:蔡晓频,王瑶,佟杰,杨兆军,张金苹,何一凡,李光伟
【摘要】目的评价甲状腺结节细针穿刺的诊断价值。方法对比分析74例甲状腺结节细针穿刺后行手术治疗患者的细胞病理学与组织病理学诊断结果,判断细胞病理学诊断的准确性,分析细胞病理学诊断中漏诊及误诊的常见原因。结果组织病理学诊断良性病变48例(占65%),恶性肿瘤22例(占30%),良性肿瘤4例(占5%)。细胞病理学诊断良性病变或恶性病变与组织病理学的符合率分别为96%和94%。15例诊断不符合病例主要来自于滤泡性肿瘤诊断组,其主要原因是细胞学诊断错误及腺瘤性结甲和滤泡性肿瘤间重叠的细胞学特征。结论甲状腺结节细针穿刺虽有一定的局限性,但诊断良性病变或恶性病变准确性高,具有重要诊断价值。
【关键词】甲状腺结节;细针穿刺;细胞病理;组织病理
ABSTRACT: Objective To investigate the diagnostic value of fineneedle aspiration (FNA) for thyroid nodules. Methods The cytological and histological results of 74 patients who had undergone FNAs for thyroid nodules, followed by thyroidectomy, pared to evaluate the accuracy of cytological diagnosis of thyroid FNA and analyze mon causes of missed diagnosis and misdiagnosis in thyroid cytopathology. Results Benign lesions were histologically diagnosed in 48 patients (65%), malignant tumors in 22 cases (30%) and benign tumors in 4 cases (5%). Cytological diagnosis of benign and malignancy was confirmed histolopathologically in 96% and 94%, respectively. Fifteen discrepant cases came mainly from the group of FNA diagnosis of follicular neoplasm, and the discrepancies resulted mainly from cytodiagnostic errors and overlapping cytological features between adenomatoid nodule and follicular neoplasm. Conclusion Despite some limitations, thyroid fineneedle aspiration