甲状腺细针穿刺细胞学漏诊与误诊15例分析

发布时间：2018-06-27 07:25

本文选题：甲状腺细针穿刺细胞学 + 超声引导　；参考：《临床与实验病理学杂志》2017年08期

【摘要】：目的探讨甲状腺细针穿刺细胞学(fine needle aspiration cytology,FNAC)诊断甲状腺良、恶性病变漏诊率与误诊率。方法收集980例甲状腺患者在超声引导下行FNAC检查,并分析15例甲状腺FNAC检查漏诊与误诊的原因,以及195例穿刺后行手术患者的FNAC诊断结果与术后病理诊断的一致性。结果FNAC结果提示恶性检出率为11.4%(112/980),穿刺后行手术的患者195例,术后病理诊断良性128例,FNAC诊断符合率为91.40%(117/128)。术后病理诊断,乳头状癌60例,FNAC诊断符合率为92.22%(56/60);FNAC检查误诊11例,漏诊4例。结论超声引导下甲状腺FNAC检查对甲状腺术前良、恶性病变的诊断,尤其对乳头状癌的诊断有一定的漏诊率和误诊率,存在一定的局限性。随着细胞学研究的不断深入,联合基因学及免疫组化协助诊断,更好地提高甲状腺FNAC的诊断水平。
[Abstract]:Objective to investigate the rate of missed diagnosis and misdiagnosis of benign and malignant thyroid lesions by (fine needle aspiration cytology. Methods 980 patients with thyroid gland were examined with FNAC under the guidance of ultrasound. The causes of missed diagnosis and misdiagnosis in 15 patients with thyroid FNAC were analyzed. The results of FNAC diagnosis in 195 patients undergoing operation after puncture were consistent with the postoperative pathological diagnosis. Results the positive rate of FNAC was 11.4% (112 / 980), 195 patients underwent operation after puncture and 128 cases of benign FNAC were diagnosed by pathology after operation. The diagnostic coincidence rate of FNAC was 91.40% (117 / 128). The diagnostic coincidence rate of FNAC in 60 cases of papillary carcinoma was 92.22% (56 / 60) misdiagnosed in 11 cases and missed in 4 cases. Conclusion Ultrasound-guided FNAC has some limitations in the diagnosis of benign and malignant thyroid lesions, especially in the diagnosis of papillary carcinoma. With the development of cytological research, the diagnosis of thyroid FNAC can be improved by combining gene and immunohistochemistry.
【作者单位】：甘肃省肿瘤医院病理诊断中心;
【基金】：甘肃省卫生行业计划管理项目(GWGL2014-39)
【分类号】：R581

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