在AUS甲状腺细胞学中的诊断偏差:感知分子测试的作用
Olcay Kurtulan1, Irem Kilic2, Hanife Avcı3
1Department of Pathology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Diagnostic cytopathology
|February 3, 2026
概括
意识到一个积极的分子测试结果的偏见甲状腺细胞学解释. 病理学家更有可能诊断不确定的意义 (AUS) 的非典型病例是恶性的,当他们认为分子测试是阳性的,影响诊断的客观性.
科学领域:
- 细胞病理学 细胞病理学
- 手术病理学手术病理学
- 分子病理学分子病理学
背景情况:
- 意义不明的非典型性 (AUS) 是一个有争议的甲状腺细胞学类别,容易产生解释性偏见.
- 这项研究调查了分子测试结果对AUS诊断的影响.
研究的目的:
- 评估一个积极分子测试的知识是否会影响甲状腺细针吸收 (FNA) 标本的细胞学解释,诊断为AUS.
- 量化感知分子测试对诊断重新分类的影响.
主要方法:
- 选择了20例甲状腺FNA病例,诊断为AUS,并进行良性随访.
- 参与者评估了带有和没有"阳性ThyroSeq测试"信息的幻灯片 (没有实际测试).
- 该研究基于感知到的分子阳性度来测量重新分类率.
主要成果:
- 无论分子测试信息如何,AUS仍然是占主导地位的诊断 (64%).
- 假定阳性分子测试导致更多的瘤或恶性诊断 (24%对12%,p=0.023).
- 这种偏差在AUS-N病例中最为显著,观察者之间总体一致性较差 (kappa=0.046).
结论:
- 感知到的阳性分子测试结果显著增加了将AUS病例重新归类为可疑或恶性病例的可能性.
- 细胞学解释中的认知偏差必须被识别和减轻,以便准确诊断.
- 保持诊断客观性对于基于证据的甲状腺细胞学评估至关重要.
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