甲状腺细针穿刺活检在桥本甲状腺炎诊断中的应用

目的：探讨甲状腺细针穿刺活检（FNAB）在桥本甲状腺炎诊断中的应用。方法：分析2005年5月￣2007年12月在中日友好医院行甲状腺FNAB患者的临床资料。结果：在行FNAB患者中,桥本甲状腺炎是甲状腺肿大和甲状腺功能低减的首位病因,是甲状腺结节的第二位病因。而以甲状腺过氧化物酶（TPO）或甲状腺球蛋白（TG）抗体阳性诊断的敏感性为69.5%,患者可处于多种甲状腺功能状态。27%表现为甲状腺功能亢进（甲亢）或亚临床甲亢,9%患者TPO、TG两抗体均阴性。6例合并甲状腺癌。结论：甲状腺FNAB对不典型病例如TPO、TG抗体阴性,伴结节以及以颈部疼痛为主要表现的桥本甲状腺炎的诊断有确诊意义,对于格雷夫病甲亢与桥本甲亢及桥本一过性甲亢有鉴别意义,特别对桥本甲状腺炎合并甲状腺癌的诊断有重要意义。

Clinical application of fine needle aspiration biopsy in diagnose of Hashimoto''s thyroiditis

Objective:To investigate the value of fine needle aspiration biopsy(FNAB)in diagnosis of Hashimoto's thyroiditis(HT).Methods:We analyzed clinical data from 393 HT diagnosed with FNAB.Results:HT was the first cause of thyroid goiter and hypothyroidism and second cause of thyroid nodule.The diagnostic sensitivity of thyroid peroxidase(TPO)or thyroglobulin(TG)antibody positive was only 69.5%.Patients could be in various thyroid function state.Among them,27% subjects were thyrotoxicosis(sub-clinical thyrotoxicosis),9% subjects were TPO and TG antibody negative.Six patients were suspicious as coexist with thyroid carcinoma.Conclusion:FNAB can confirm the diagnosis of HT when patients are TPO and TG antibody negative,with nodules or neck pain.It can also differentiate thyrotoxicosis induced by Graves' disease,Hashitoxicosis or transient thyrotoxicosis.It is especially useful in the diagnosis of HT coexistent with thyroid carcinoma.