细针吸取细胞学诊断甲状腺结节的探讨

目的：探讨细针吸取细胞学诊断甲状腺结节的准确性及误诊因素。方法：对3939例甲状腺结节进行了细针吸取细胞学检查，其中581例获病理组织学对照。细胞学诊断分四类：良性、恶性、可疑恶性和标本不足。结果：细胞学诊断良性占42％(248／581)，恶性占17％(98／581)，可疑恶性占29％(167／581)，标本不足占12％(68／581)。细胞学诊断敏感性为68％(95／140)，特异性为99％(438／441)。结论：仔细检查甲状腺、坚持严格的细胞学诊断标准、标本不足重复穿刺，对提高细针吸取细胞学诊断甲状腺结节的准确率有重要意义。

The Diagnostic Value to Thyroid Nodules by Fine Needle Aspiration Cytology

Objective:To study the cytological accuracy,misdiagnostic factors and diagnos-tic report forms by FNA(fine needle aspiration)cytology in thyroid nodules.Methods:Total3939thyroid nodules of FNA were performed and581cases of them were checked with the histological diagnosis.The cytological diagnosis were classified four types:benign,malignant,doubtful malig-nant and inadequate specimens.Results:The benign diagnostic rate,the malignant,the doubtful malignant and the inadequate specimens were42%(248/581),17%(98/581),29%(167/581)and12%(68/581)respectively.The sensitivity and the specificity of cytological diagnosis were68%(95/140)and99%(438/441)respectively.Conclusions:It is important for improving the accuracy rate of FNA to examine thyroid carefully,to perform the operation by the same doctor,to repeat the aspiration for the inadequate specimens,to insist on strict diagnostic criteria,to base on the scheme of classification+terminology of disease.