超声波未确诊的3/4a甲状腺结节的细胞和组织病理学特征
W U Wei-Qi1, X U Cun-Bao1, L I You-Jia2
1Department of Pathology,Quanzhou, Fujian 362000,China.
概括
在中国甲状腺成像报告和数据系统 (C-TIRADS) 3类和4a类中,未被确诊的甲状腺结节,特别是乳头甲状腺癌,显示出比预期更高的恶性瘤率. 对细胞和组织病理特征的进一步分析对于准确的诊断至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
背景情况:
- 中国甲状腺成像报告和数据系统 (C-TIRADS) 根据超声特征对甲状腺结节进行分类,以分层恶性瘤风险.
- 在较低的C-TIRADS类别 (3和4a) 内的恶性甲状腺结节的低诊断可能导致治疗延迟.
- 了解这些诊断不足的结节的特定细胞和组织病理特征对于提高诊断准确性至关重要.
研究的目的:
- 分析C-TIRADS类别3和4a的未被诊断的甲状腺结节的细胞和本病学特征.
- 提高对这些特定甲状腺病变的理解和诊断准确度.
- 为了将观察到的恶性瘤率与既定指南进行比较.
主要方法:
- 超声波和精细针吸收细胞学数据的回顾性分析来自549名接受手术的患者中的683个甲状腺结节.
- 病理证据被用作诊断的黄金标准.
- 系统地评估了C-TIRADS 3和4a结节的细胞和组织病理学特征.
主要成果:
- 在C-TIRADS 3类结节中,恶性瘤发生率为7.46%,在C-TIRADS 4a类结节中,恶性瘤发生率为36.65%.
- 这两个类别的恶性瘤发病率明显高于C-TIRADS指导方针的推 (P < 0.001).
- 未确诊的C-TIRADS 3/4a结节主要是乳头甲状腺癌,特别是在哈希莫托甲状腺炎患者中;超声波和细胞学相关性对于低风险结节是不一致的.
结论:
- 乳头甲状腺癌 (特别是哈希莫托甲状腺炎),卵泡癌和髓癌经常被低诊断为C-TIRADS 3或4a结节,当恶性特征在术前超声波上不典型或不存在时.
- 需要更好地了解这些病变的细胞和病理特征,以改善手术前风险分层.
- 目前的C-TIRADS指南可能低估了类别3和4a中的某些结节的恶性瘤风险.
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