针吸细胞学检查与甲状腺激素及自身抗体测定对桥本氏病的诊断

目的　对甲状腺桥本氏病 (Hashimoto’sThyroiditioHT)的FNAC诊断及血清甲状腺激素、抗体测定值进行评价。方法　细针吸取细胞学涂片 ,HE染色镜下观查 ,与血清甲状腺激素FT3、FT4、TSH及甲状腺球蛋白抗体 (TGA)甲状腺微粒体抗体 (TMA)的测定进行对比分析。结果　FNAC诊断的 346例甲状腺桥本氏病可较准确分型 :淋巴细胞型(2 0 2 /346 ) 5 8 4 % ;嗜酸性变型 (15 6 /346 ) 4 5 1% ;上皮破坏型 (5 2 /346 ) 15 0 2 % ;纤维化型 (18/346 ) 5 2 %。甲状腺激素测定多数大致正常占 (180 /346 ) 5 2 0 2 % ;功能低下者占 (12 0 /346 ) 34 6 8% ;功能亢进者占 (46 /346 ) 13 2 9%。其中 30 6例同时测定TGA阳性率占 (195 /30 6 ) 6 3 72 % ;TMA阳性率占 (2 30 /30 6 ) 75 16 % ,均低于 80 %。结论　甲状腺桥本氏病的FNAC细胞特点突出 ,分型诊断较准确 ,检测FT3、FT4、TSH及TGA、TMA可有效的提高FNAC对桥本病的诊断 ,降低甲状腺自身免疫性疾病误诊率

The analysis of fine needle aspiration cytology examanition and thyroid hormorn measure to Hashimmoto'''' s Thyroiditio

Objective To discuss the value of fine needle aspiration cytology(FNAC) and hormorn measure to Hashimmoto's Thyroiditio(HT).Methods Methods HT diagnosed by FNAC compare to hormorn FT3 FT4 TSH TGA TMA. Results 346 HT disgnosed by FNAC may classify correctly:lymphocyte type(202/346)58 4%, acidophilic type(156/346)45 1%, epithelium destroy type(52/346)15 02%, fibrosis type(18/346)5 2%, the hormorn level of majority are normal(180/346)52 02%, dysthyroiddism(120/346)34 68%, hyperthyroidism(46/346)13 29%. 306 cases measured TGA and TMA at the same time, their positive rates are(195/306)63 72% and (230/306)75 16% respectively. Conclusion ons the features of cells is obvious, the classic diagnosis is correct. measuring hormorn can help FNAC diagnose HT and relieve mistake.