背景:甲状腺结节的病理学在所有年龄段都存在,并且在临床实践中经常遇到。甲状腺结节不代表单一疾病,但它们是各种不同甲状腺疾病的临床表现。
目的:这项研究的目的是评估孤立性闪烁显像冷结节中恶性肿瘤的频率和定位,以及灵敏度,与组织病理学结果相比,FNAB的特异性和诊断准确性。
方法:该研究包括49例患者,这些患者的孤立性结节位于甲状腺的两个叶部或峡部。所有受试者都接受了闪烁显像和FNAB,然后将细胞学结果与最终的组织病理学诊断进行比较,手术后。
结果:研究结果表明,孤立性结节的数量最高(81,6%)位于甲状腺两个叶的下极。细胞学结果为良性8例,恶性23例,不确定(滤泡性肿瘤)18例。在细胞学诊断为滤泡性肿瘤的患者中,经组织病理学证实的甲状腺癌数量最高。即,在66.7%的受试者中发现滤泡癌,在33.3%的受试者中发现乳头状癌。最常见的癌症是乳头状癌,占61.2%。由于我们所有患者的病理组织学诊断都对癌症有反应,对细胞学方法对甲状腺恶性病变的诊断敏感性进行了间接统计评估,这是83.7%。
结论:FNAB是一种高度敏感的甲状腺恶性病变诊断方法,灵敏度Se=83,7%。在细胞学诊断为滤泡性肿瘤的患者中,经组织病理学证实的甲状腺癌数量最高(66.7%)。细胞学诊断为乳头状癌的患者数量最多。
BACKGROUND: Pathology of thyroid nodules is present in all ages and it is frequently encountered in clinical practice. Thyroid nodules do not represent a single disease, but they are the clinical manifestation of a wide range of different thyroid diseases.
OBJECTIVE: The objective of this study is to evaluate the frequency and localization of malignancy in solitary scintigraphic cold nodules, as well as the sensitivity, specificity and diagnostic accuracy of FNAB in comparison with histopathological findings.
METHODS: The study was included 49 patients with palpatory findings of the solitary nodule located in the both lobes or isthmus of thyroid gland. All subjects underwent the scintigraphy and FNAB, followed by a cytologic results that was compared to the final histopathological diagnosis, after surgery.
RESULTS: The study results show that the highest number of solitary nodules (81,6%) is localized in the lower pole of the both lobes of the thyroid gland. The cytologic results were benign 8 cases, malignant in 23 and indeterminate (follicular neoplasm) in 18 cases. The highest number of thyroid cancer is histopathologically confirmed in the patients with cytological diagnosis of follicular neoplasms, i.e. follicular cancer is found in 66.7% and papillary cancer is found in 33.3% of subjects. The most common cancer is papillary cancer found in 61,2%. Since the pathohistological diagnosis of all our patients responded to cancer, it was done indirect statistical evaluation of the diagnostic sensitivity of cytological method in the estimation of malignant thyroid lesion, which was 83,7%.
CONCLUSIONS: FNAB is a highly sensitive method in the diagnostics of malignant thyroid lesions with the sensitivity Se=83,7%. The highest number of thyroid cancer is histopathologically confirmed in the patients with cytological diagnosis of follicular neoplasm (66.7%). The highest number of patients had a cytological diagnosis of papillary cancer.