超声引导下甲状腺细针穿刺活检992例的临床与病理分析

发布时间：2018-04-05 10:45

本文选题：甲状腺　切入点：细针穿刺　出处：《广东医学》2017年04期

【摘要】：目的探讨超声引导下甲状腺细针穿刺活检(US-FNAB)的临床价值,及常见甲状腺疾病,特别是甲状腺微小乳头状癌(PTMC)的细胞学特征。方法收集行US-FNAB的992例采用Bethesda报告系统诊断的甲状腺结节,对其细胞学诊断分类、术后组织学诊断、PTMC的细胞学特征及US-FNAB开展前后甲状腺手术疾病构成的变化进行统计分析。结果 (1)通过统计317例经组织学确诊的病例,得出US-FNAB的敏感性为99.6%,特异度为93.2%,准确度为98.4%。(2)在90例PTMC中,20%可见典型乳头状结构,98.9%可见排列拥挤周缘不规则成角的单层片块状结构。(3)同2013年开展US-FNAB前相比:甲状腺癌在甲状腺手术中所占比例由33.6%上升为47.4%,其他良性病变由8.9%下降为1.2%。结论 US-FNAB是一项精准可靠的术前诊断方法,能提高甲状腺癌的检出率。大部分PTMC细胞学较难明确诊断;排列拥挤周缘不规则成角的单层片块状结构对PTMC有重要诊断价值。
[Abstract]:Objective to investigate the clinical value of ultrasound guided fine needle biopsy of thyroid gland (US-FNAB) and the cytological characteristics of common thyroid diseases, especially thyroid micropapillary carcinoma (PTMC).Methods A total of 992 cases of thyroid nodules diagnosed by Bethesda report system were collected and classified into cytological diagnosis, histologic diagnosis, cytological features and changes of thyroid operating diseases before and after US-FNAB.Results 1) 317 cases confirmed by histology were counted.The proportion of cancer in thyroid surgery increased from 33.6% to 47.4%, and other benign lesions decreased from 8.9% to 1.2%.Conclusion US-FNAB is an accurate and reliable preoperative diagnostic method and can improve the detection rate of thyroid carcinoma.Most of PTMC cytology is difficult to diagnose clearly, and it is important to diagnose PTMC with the monolayer and block structure arranged around crowded edges irregularly.
【作者单位】：北京大学深圳医院病理科;首都医科大学附属北京友谊医院病理科;北京大学深圳医院超声科;
【分类号】：R736.1

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