甲状腺结节细针穿刺活检临床价值评价

目的评价甲状腺结节细针穿刺活检的诊断价值。方法回顾性分析首都医科大学大兴医院近年98例甲状腺结节的临床资料。结果甲状腺结节细针穿刺活检的敏感度、特异度、准确率分别为:75%、91%、87.7%,对滤泡性病变的诊断准确性较差。结论细针穿刺活检对于甲状腺结节是一种有价值的诊断方法。     

甲状腺粗针穿刺活检对甲状腺疾病的诊断

甲状腺粗针穿刺活检对甲状腺疾病的诊断昆明医学院第一附属医院（６５００３２）杨慧英，汤保德甲状腺粗针穿刺活检是在细针穿刺抽吸细胞学检查基础上发展起来的一项新技术，本文介绍６５例甲状腺疾病的穿刺结果，旨在探索其对甲状腺疾病的诊断价值。对象和方法一、对象：...     

甲状腺细针穿刺活检在甲状腺炎性疾病中的应用

探讨甲状腺细针穿刺活检(FNAB)在甲状腺炎性疾病诊断中的应用。分析行甲状腺FNAB并符合甲状腺炎性疾病共120例患者的临床资料。结果:甲状腺FNAB能准确诊断甲状腺炎性疾病;亚急性甲状腺炎和无痛性甲状腺炎发病时年龄较慢性淋巴细胞性甲状腺炎低;甲状腺炎性疾病女性发病率远高于男性,特别是自身免疫性甲状腺疾病(AIT);甲状腺FNAB对不同类型的甲状腺炎性疾病的诊断有确诊意义。     

甲状腺细针穿刺的护理与并发症预防

目的讨论分析甲状腺细针穿刺患者的护理以及并发症的预防。方法 40例甲状腺细针穿刺患者作为观察对象,对其进行相应护理干预,并对术中、术后并发症情况进行观察以及预防。结果经过相应护理干预手段,40例患者甲状腺细针穿刺成功率为100%,并发症发生率也有所减少。结论甲状腺细针穿刺患者经过相应护理干预手段能够增加穿刺成功率,减少并发症的发生。     

细针吸取细胞学检查在甲状腺疾病诊断中的应用分析

目的研究分析细针吸取细胞学检查应用于甲状腺疾病的临床诊断。方法择取2013年10月至2014年10月在我院采取细针吸取细胞学检查的158例患者,回顾性探析其诊断资料。结果本组158例患者中,结节性甲状腺肿的检出率最高,约为33.54%(53/158),明显高于其他甲状腺疾病的检出率,差异P<0.05有统计学意义。其中,明确诊断者144例(91.14%),未明确诊断者14例(8.86%)。结论细针吸取细胞学检查应用于甲状腺疾病的诊断准确率较高,具有快捷、安全以及准确的特点。     

甲状腺结节细针穿刺活检的临床价值评价

目的研究甲状腺结节细针穿刺活检的临床价值,提高临床疾病的诊断率。方法随机抽取80例于2011年7月至2012年7月,在我院接受甲状腺结节诊治患者的资料,对甲状腺结节症状的良性、恶性等情况实施诊断。80例分为观察组、对照组,每组40例,观察组采用细针穿刺活检,对照组采用甲状腺功能测定、核素扫描、超声波检查等常规方法;对比细针穿刺活检的诊断率。结果对比两组40例的诊断结果,观察组细针穿刺活检的敏感性、特异性、准确性、阳性预告值、阴性预告值等指标均优于对照组,两组检查的准确率差异性显著(P<0.01)。结论对甲状腺结节者使用细针穿刺活检的临床价值较高,可推广于甲状腺结节的检查。     

甲状腺细针穿刺治疗甲状腺囊肿的临床应用

我院门诊从 1998年开展甲状腺细针穿刺治疗甲状腺囊肿 2 4例 ,近期效果满意 ,现报告如下。1　临床资料1.1　一般资料 :甲状腺囊肿 2 4例 ,年龄 31～ 6 8岁 ,平均 41岁 ,男 9例 ,女 15例。病程 2 d～ 9个月 ,全部患者的血清总T3、T4、甲状腺球蛋白抗体 (TGA )、甲状腺微粒体抗体(TMA)、促甲状腺激素 (TSH)均正常 ,其中 8例加作甲状腺及 I1 3 1 率均正常。1.2　方法 :用 10 m L或 2 0 m L注射器 ,配 9号针头在负压下沿甲状腺肿大处不同方向抽吸 ,1～ 5次不等 ,其中 3例患者在经数次抽吸后最后一次囊腔内注射 95 %的酒精作为硬化剂治疗。…     

甲状腺细针穿刺细胞学检查60例病理诊断

甲状腺疾病包括功能性、炎症性及肿瘤性疾病.甲状腺疾病的定性诊断对治疗是至关重要的.细针穿刺细胞学检查(FNAC),具有快捷、准确、经济和安全等优点.因此探讨甲状腺细针穿刺细胞学检查的病理形态及鉴别诊断,对临床治疗甲状腺疾病有重大意义.     

细针穿刺吸取细胞学诊断甲状腺疾病研究

目的通过细针穿刺吸取甲状腺肿物细胞学涂片的形态学分析,研究细针穿刺吸取细胞学在甲状腺疾病中的诊断价值。方法对本组130例甲状腺疾病患者细针穿刺吸取细胞徐涂片,镜下进行形态学分析做出细胞学诊断,并于术后病理学诊断作比较。结果本组病例细胞学诊断甲状腺肿物符合率为95.4%。结论细针穿刺吸取细胞学对甲状腺肿物的诊断具有操作简便,准确率高等优点,可作为甲状腺肿物的诊断方法之一,应广泛应用。     

The role of fine-needle aspiration biopsy in the management of patients with thyroid nodules

Fine-needle aspiration biopsy (FNAB) of the thyroid gland is the most cost-effective examination in the evaluation of thyroid nodules. The aim of this study was to present our experience from all patients who underwent thyroid FNA in the University Hospital of Ioannina, Greece, in the period 1993-2003, and its value in the diagnostic management of patients with thyroid nodules. FNA was performed in 900 patients of whom 753 were females and 147 males. The cases were classified according to diagnosis into five groups: benign/negative 628, primary carcinoma 28, metastatic carcinoma 5, suspicious/indeterminate 60 and non-diagnostic 179. Cytological findings were compared with histopathological findings and the statistical analysis in our data yielded the following results: sensitivity 92.1%, specificity 93.2%. These results are in accordance with the already published data in the international literature. In cases of differential diagnosis between adenomatoid hyperplasia and follicular neoplasia, four cases were diagnosed as hot nodules. In the benign group, three cases were diagnosed as nodular hyperplasia with cystic degeneration on FNA, but, after surgical treatment, histologically were diagnosed as papillary carcinomas. In the group of suspicious/indeterminate, two cases were diagnosed as suspicious for follicular neoplasia on FNA and, after surgical treatment, were diagnosed histopathologically as medullary carcinomas. In conclusion, we suggest that routine measurement of serum calcitonin is useful and mandatory in the detection of medullary carcinoma among patients with nodular thyroid diseases. Taking into consideration the clinical data can minimize false-positive and false-negative rates. We conclude that FNA is an effective screening test in the evaluation of the necessity for surgical treatment in patients with thyroid nodules.     

The use of fine-needle aspiration biopsy for the diagnosis of hepatic steatosis in rats

The usefulness and safety of the fine-needle aspiration biopsy (FNAB) technique for the study of liver cell changes were evaluated in rats. Repeated punctures of the same liver lobe (40 punctures in 10 weeks) caused small necroses and hemorrhages which were rapidly organized without significant distortion of the liver structure. Fatty change induced by a high fat diet was recognized in cytological smears stained with Fettrot 7B, and its progression with time monitored. The cytologie findings correlated well with histopathological and biochemical changes observed in the same animals.     

60例非甲状腺颈部肿块细针穿刺临床病理诊断分析

目的:探讨非甲状腺颈部肿块细针穿刺病理诊断特点。方法:对2013年1月—2013年6月病理科颈部肿块细针穿刺标本60例进行回顾性分析。结果:60例标本中,炎性肿块21例,先天性肿块2例,新生物肿块37例;发病部位为腮腺、颌下腺、涎腺、锁骨上淋巴结及颈部淋巴结。各种肿块有不同临床特点。结论:病理医生应根据细针吸取细胞学病理诊断结合颈部肿块临床特征,对颈部肿块作出正确诊断,为肿块的临床治疗提供依据。     

CT引导下穿刺活检在诊断脊柱病变的应用

目的:探讨CT引导下穿刺活检术在脊柱疾患诊疗中的作用。方法:36例脊柱病变患者,包括颈椎3例,胸椎10例,腰椎20例,骶椎3例,采用CT监测下经皮穿刺活检的方法获得病理诊断。结果:36例中,33例获得明确病理诊断,活检阳性率为91.6%,无并发症发生。结论:CT引导下穿刺活检是脊柱病变术前明确诊断的有效方法,其安全、准确率高、费用低,对制定脊柱病变的综合治疗方案起重要的作用。     

Comparison of core-needle biopsy and fine-needle aspiration in screening for thyroid malignancy: a systematic review and meta-analysis

Objective: Core-needle biopsy (C.N.B.) is a procedure that is usually performed after repeated non-diagnostic fine-needle aspiration (F.N.A.) or in combination with F.N.A. in the detection of thyroid malignancy. The purpose of this study was to: (1) compare the accuracy of C.N.B. and F.N.A. in the detection of thyroid malignancy; (2) evaluate the accuracy of C.N.B. in nodules with prior non-diagnostic F.N.A. results.

Methods: Meta-analysis was performed with Comprehensive Meta-Analysis statistical software, version 2.0. A bivariate approach of hierarchical summary R.O.C. was performed using R software. Study quality was assessed with the Cochrane Risk of Bias Tool. Publication bias analysis was performed by funnel plot and Egger’s test analysis.

Results: The main results of our study are as follows. 1) Overall C.N.B. had fewer non-diagnostic results than F.N.A. (pooled O.R. = 4.93, 95% C.I.: 2.17–11.19). Pooled sensitivities and specificities of C.N.B. and F.N.A. did not differ significantly. (2) There was no significant difference in the rates of non-diagnostic results of first-line F.N.A. and C.N.B. (O.R. = 2.42, 95% C.I. 0.95–6.18). Pooled sensitivities and specificities did not differ significantly. C.N.B. yielded fewer non-diagnostic results compared to repeated F.N.A. (O.R. = 19.13, 95% C.I. 7.08–51.65) for thyroid cancers with prior non-diagnostic F.N.A. results. The A.U.C.s of the hierarchical summary R.O.C. (H.S.R.O.C.) were 0.669 for repeated F.N.A. and 0.984 for C.N.B. with separated confidence regions for sensitivity and false positive rate.

Conclusion: C.N.B. has higher diagnostic accuracy than repeat F.N.A. for thyroid nodules with prior non-diagnostic F.N.A. results. There is no significant difference in the diagnostic performance of C.N.B. and F.N.A. as first-line diagnostic tools.     

甲状腺结节细针穿刺细胞学检查的护理

目的：探讨甲状腺结节细针穿刺细胞学检查护理的意义。方法：对甲状腺结节穿刺的患者进行术前、术中和术后护理,观察护理效果。结果：通过护理患者减轻了紧张恐惧心理。结论：对甲状腺结节穿刺患者进行护理,能够有效的缓解患者的情绪,提高了甲状腺结节诊断的准确率。     

细针抽吸细胞学检查对甲状腺疾病的诊断探讨(附418例分析)

目的：探讨细针抽吸细胞学检查（Fine-Needle Aspiration)在甲状腺某些疾病中的诊断意义。方法：对418例甲状腺疾病做细针抽吸细胞学检查。结果：418例甲状腺细针抽吸细胞学检查对6类甲状腺疾病做出细胞学诊断；甲状腺腺瘤68例占16．26％，结节性甲状腺肿47例占11．24％，桥本甲状腺炎145例占34．68％，弥漫毒性甲状腺肿128例占30．62％，亚急性甲状腺炎5例占1．20％，甲状腺癌25例占6％。尤其是对桥本甲状腺炎和甲状腺良恶性病变的鉴别，以及甲状腺乳头状癌的诊断有较高的参考价值。结论：FNA是甲状腺疾病诊断的较好方法。     

Clinical usefulness of KRAS mutational analysis in the diagnosis of pancreatic adenocarcinoma by means of endosonography-guided fine-needle aspiration biopsy

AIM: To establish the usefulness of KRAS mutational analysis in the diagnosis of pancreatic adenocarcinoma by comparing this technique with conventional cytology in aspirates obtained by endosonography-guided fine-needle aspiration. METHODS: All consecutive patients with pancreatic focal lesions undergoing endosonography-guided fine-needle aspiration were included. Samples were obtained with the concurrence of an attendant cytopathologist. Detection of codon-12 KRAS mutations was performed by the restriction fragment length polymorphism-polymerase chain reaction method. The effectiveness of conventional cytology, KRAS mutational analysis and their combination was established with respect to the definitive diagnosis. A cost-effectiveness analysis was also performed. RESULTS: Thirty-three patients had pancreatic adenocarcinoma and 24 patients had other lesions. A total of 136 samples was obtained. In patients in whom specimens were adequate (93% for cytology; 100% for mutational analysis), the specificity of both techniques was 100%, whereas the sensitivity favoured cytology (97% vs. 73%). When inadequate samples were considered as misdiagnosed, a combination of both techniques reached the highest overall accuracy (cytology, 91%; mutational analysis, 84%; combination of both, 98%). CONCLUSIONS: Cytology from aspirates obtained by endosonography-guided fine-needle aspiration is the most precise single technique for the diagnosis of pancreatic adenocarcinoma. However, when adequate specimens are not available to reach a cytological diagnosis, the addition of KRAS mutational analysis represents the best strategy.     

Application of fine-needle aspiration biopsy for the diagnosis of dysplastic and neoplastic liver cell changes induced by N-nitrosomorpholine in rats

Male rats were treated with the hepatocarcinogen, N-nitrosomorpholine (NNM, 10 mg ad 100 ml drinking water) for 19 weeks. Repeated fine-needle aspiration biopsies of the liver were performed percutaneously. Cytomorpho-logic and cytochemical criteria were used for the characterization of dysplastic and carcinoma cells. The alterations seen in the smears were correlated with histopathologic findings in the punctured liver lobes. Cells showing type I dysplasia were recognized in smears obtained from day 7 on. They corresponded to the swollen, glycogen-free cells developing in zone 3 of the Rappaport acinus during the early treatment phases. In later stages type II dysplastic cells were observed in smears. This coincided with the development of neoplastic nodules seen in histopathologic preparations. Carcinoma cells were recognized first after 15 weeks. Marked -glutamyl transpeptidase (-GT) activity could be demon-strated cytochemically in biopsy smears and biochemically in biopsy homogenates during the early phases of NNM-treatment. Simultaneously, a rise in -GT activity was also observed in the serum.