没有诊断的甲状腺细针的命运愿望
Tanner Storozuk1, Anna Biernacka1, Ricardo Lastra1
1Department of Pathology, University of Chicago, Chicago, Illinois, USA.
Diagnostic cytopathology
|July 25, 2024
概括
非诊断的甲状腺细针吸收 (FNA) 结果通常是良性的. 重复FNA或手术切除很少显示恶性瘤,这表明对于这些甲状腺结节,临床随访可能足够.
科学领域:
- 内分泌学 在内分泌学.
- 细胞病理学 细胞病理学
- 手术瘤学手术瘤学
背景情况:
- 甲状腺结节很常见,通常是偶然发现的或在甲状腺激素水平工作期间检测到的.
- 在超声波指导下的细针吸收 (FNA) 是甲状腺结节的主要诊断工具.
- 根据贝塞斯达系统的定义,未被诊断的甲状腺FNA缺乏足够的毛囊细胞来进行最终分类.
研究的目的:
- 为了评估重复细针吸收 (FNA) 对非诊断性甲状腺结节的诊断产量.
- 评估非诊断性FNA后的患者管理和结果.
- 为了确定最初未被诊断的甲状腺FNA结果的患者的恶性瘤率.
主要方法:
- 甲状腺FNA在2016年至2023年期间进行的回顾性审查.
- 根据贝塞斯达系统,对被归类为未诊断的病例进行分析.
- 评估后续手术,包括重复FNA,分子测试和手术切除.
主要成果:
- 在3104个甲状腺FNA中,4.9%是未被诊断的.
- 在50名患者中,重复FNA在67%的患者中产生良性结果,在24%的患者中再次无诊断,并在9%的患者中显示出不确定的意义 (AUS) 的异型.
- 对AUS病例和手术切除 (17例) 的分子检测只发现了一种非侵入性卵泡瘤和偶发的乳头小瘤;没有发现原发性恶性瘤.
结论:
- 非诊断的甲状腺细胞学高度预测良性结节状况.
- 重复采样或切除很少会发现显著的甲状腺病理.
- 临床和超声监测可能是非诊断性甲状腺FNA的合适管理策略.
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