Long-term follow-up of patients with benign thyroid fine-needle aspiration cytologic diagnoses.
Long-term follow-up of patients with benign thyroid fine-needle aspiration cytologic diagnoses.
复制标题
甲状腺良性细针抽吸细胞学诊断患者的长期随访。
作者：
C. Grant;I. Hay;I. Gough;P. McCarthy;J. Goellner
依赖甲状腺细针抽吸(FNA)作为是否只观察还是手术的关键决定因素，取决于是否达到最小的假阴性错误率(FNA诊断为良性结节的恶性疾病发生率)。为了提供令人信服的数据，恶性疾病并未被忽视，需要对大量细胞学良性病变患者进行长期随访。我们研究的目的是评估基于甲状腺FNA的诊断的长期准确性--特别是关于假阴性错误。从我们8000多名患者的总体经验中，我们回顾了1980年接受FNA的680名患者的病例，这是我们临床使用FNA的第一年。641例(94%)的患者获得了随访信息，平均自FNA以来的时间为6.1年。在这些患者中，439例(68%)报告了良性细胞学结果，只有3例(0.7%)有假阴性诊断。24例(4%)抽吸阳性患者假阳性率为0%。FNA是一种安全、可靠、有效的准确鉴别甲状腺良恶性病变的方法。
Reliance on fine-needle aspiration (FNA) of the thyroid as the key determinant whether to observe only or proceed surgically is predicated on achieving a minimal false-negative error rate (the incidence of malignant disease in nodules diagnosed benign by means of FNA). To provide convincing data that malignant disease has not been overlooked requires extended follow-up on a large number of patients with cytologically benign lesions. The intent of our study was to assess the long-term accuracy of thyroid FNA-based diagnoses--particularly with respect to false-negative errors. From our total experience of more than 8000 patients, we reviewed the cases of 680 patients who underwent FNA in 1980, the first year we used it clinically. Follow-up information was obtained on 641 (94%) of the patients with a mean time since FNA of 6.1 years. Benign cytologic findings were reported on 439 (68%) of these patients, and only three (0.7%) had false-negative diagnoses. The false-positive rate was 0% for the 24 (4%) patients with positive aspirates. FNA is a safe, reliable, effective means of accurately discriminating benign from malignant thyroid lesions.