The impact of concurrent Hashimoto thyroiditis on thyroid nodule cytopathology assessed by ultrasound-guided fine-needle aspiration cytology
The impact of concurrent Hashimoto thyroiditis on thyroid nodule cytopathology assessed by ultrasound-guided fine-needle aspiration cytology
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DOI：
10.1080/00325481.2020.1739462
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发表时间：
2020-03-14
影响因子：
4.2
通讯作者：
Huang, Hui
中科院分区：
文献类型：
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作者：
Hu, Fengqiu;Yan, Zhe;Huang, Hui
目的：甲状腺结节是一种常见的临床疾病，在世界范围内非常普遍。如何鉴别结节的性质是临床医生关心的主要问题。细针穿刺细胞学检查（FNAC）在结节管理中具有既定的作用并得到充分利用。然而，不理想的非诊断和不确定率限制了它的使用，并导致一些不必要的手术。桥本甲状腺炎（HT）常与甲状腺结节合并发生。HT是否会影响结节细胞病理学诊断的准确性仍有争议。方法：收集2015年至2016年在我院行FNAC的1,063例甲状腺结节患者的病历。回顾甲状腺功能、抗甲状腺自身抗体水平、甲状腺超声记录、结节细胞学和组织病理学结果，分析HT对FNAC结果的影响。结果：共1，063例患者，平均年龄为44 +/- 13岁，回顾性分析了病理和临床数据。不同细胞学诊断的患者抗甲状腺自身抗体阳性率相当。100例患者术后经组织病理学证实并发HT。总的非诊断和不确定的细胞学率分别为11.9%和25%。抗甲状腺自身抗体阳性与阴性患者的细胞学结果非诊断性或不确定性的发生率差异均无统计学意义（P > 0.05）。组织病理学检查HT与HT阴性者之间差异无显著性（P > 0.05）。结论：同时存在HT，无论是临床上提示抗甲状腺自身抗体阳性还是病理学证实，都不太可能使FNAC对甲状腺结节的诊断成为非诊断性或不确定性。
Objective: Thyroid nodules are highly prevalent and a common clinical problem worldwide. How to identify the nature of a nodule is a major concern of clinicians. Fine needle aspiration cytology (FNAC) has an established role and is well-utilized in nodule management. However, the unsatisfactory nondiagnostic and indeterminate rates limit its usage and lead to some unnecessary surgery. Hashimoto thyroiditis (HT) is prevalently found concurrent with thyroid nodules. Whether HT can influence the accuracy of cytopathological diagnosis of nodules is still controversial. Methods: We collected medical records of 1,063 patients with thyroid nodules who had done FNAC in our hospital from 2015 to 2016. Thyroid function, anti-thyroid autoantibody levels, thyroid ultrasound records, and cytological and histopathological results of nodules were reviewed to analyze the impact of HT on FNAC outcome. Results: A total of 1,063 patients with an average age of 44 +/- 13 years old were retrospectively reviewed for pathological and clinical data. Patients with different cytological diagnoses had comparable positive rates of anti-thyroid autoantibodies. One hundred patients were confirmed to have concurrent HT by histopathology after surgery. The overall nondiagnostic and indeterminate cytology rates were 11.9% and 25% respectively. No statistical difference was found either in the rate of a nondiagnostic cytology results or in the rate of indeterminate cytology results between patients with positive anti-thyroid autoantibodies and patients with negative test for anti-thyroid autoantibodies (P > 0.05). The same was true between patients with histopathologically confirmed HT and HT-negative ones (P > 0.05). Conclusions: The presence of concurrent HT, whether clinically implied with positive anti-thyroid autoantibodies or pathologically confirmed, is unlikely to predispose an FNAC diagnosis of thyroid nodules to be non-diagnostic or indeterminate.