LARGE CYSTIC SOLID THYROID-NODULES - A POTENTIAL FALSE-NEGATIVE FINE-NEEDLE ASPIRATION
LARGE CYSTIC SOLID THYROID-NODULES - A POTENTIAL FALSE-NEGATIVE FINE-NEEDLE ASPIRATION
复制标题
DOI：
10.1016/s0039-6060(05)80105-9
复制
发表时间：
1995-12-01
期刊：
影响因子：
3.8
通讯作者：
NORTON, JA
中科院分区：
文献类型：
--
作者：
MEKO, JB;NORTON, JA
背景资料。甲状腺结节的假阴性细针吸取(FNA)活检结果特别令人担忧，因为它们意味着漏掉了恶性病变。本研究的目的是找出可能导致FNA术后细胞学假阴性的甲状腺结节的特征。我们回顾了连续90例甲状腺结节患者，包括临床资料、甲状腺结节类型和大小、FNA细胞学结果以及手术标本的最终病理报告。甲状腺结节恶变率最高的是体积较大(3 cm或以上)、囊性/实性或大而囊性/实性的甲状腺结节。术前FNA总体假阴性率为11%。大结节、囊实性结节和甲状腺结节的假阴性率分别为17%、25%和30%，而小结节(<3 cm)、实性结节和大于3 cm结节的假阴性率分别为0%、9%和17%。由于甲状腺大结节(3 cm或以上)、囊性/实性结节或大囊性/实性结节的恶性肿瘤发生率较高，且FNA对这些病变的诊断假阴性率较高，即使FNA细胞学检查结果为良性，也应强烈考虑切除甲状腺叶进行诊断。
Background. False-negative fine-needle aspiration (FNA) biopsy results of thyroid nodules are of particular concern because they imply missed malignant lesions. The purpose of this study was to identify characteristics of thyroid nodules that may lead to false-negative cytologic interpretation after FNA.Methods. We reviewed 90 consecutive patients who underwent preoperative FNA of thyroid nodules followed by thyroid surgery during a period of 27 months, including their clinical data, type and size Of thyroid nodule, FNA cytology results, and final pathology report of the surgical specimen.Results. Thyroid nodules that had the highest probability of malignancy were those that were large (3 cm or larger), cystic/solid, or large and cystic/solid. The overall false-negative rate for preoperative FNA was 11%. Large, cystic/solid, and thyroid nodules with both characteristics had false-negative rates of 17%, 25%, and 30%, respectively, compared with 0%, 9%, and 17% for small (less than 3 cm), solid, and solid nodules 3 cm or larger, respectively.Conclusions. Because of the high prevalence of malignancy in thyroid nodules that are large (3 cm or larger), cystic/solid, or large and cystic/solid and the high false-negative rate of FNA in diagnosing these lesions, thyroid lobectomy for diagnosis should be strongly considered in these patients even when FNA cytologic finding is interpreted as benign.