Bethesda细胞病理报告系统在甲状腺细针穿刺中的应用
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国家自然科学基金(30971405,81270897);国家临床重点专科培育项目;江苏高校优势学科建设工程资助项目


Application of Bethesda system for reporting cytology in thyroid fine needle aspiration
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    摘要:

    目的:将Bethesda细胞病理报告系统(TBS)应用于甲状腺细针穿刺(FNA)细胞病理读片,提高 FNA细胞病理诊断水平。方法:收集1 705份FNA细胞病理样本,同时对比分析其中66例接受外科手术的组织病理样本。结果:1 705份中病理片归为“无诊断价值”(N)-“良性”(B)-“不确定价值的不典型增生”(AUS)-“滤泡性肿瘤”(FN)-“怀疑恶性”(S)和“恶性”(M)的分别有295(17.30%)-1 291(75.72%)-30(1.76%)-19(1.11%)-36(2.11%)和34(1.99%)例。总体阳性细胞率82.70%。对66例同时接受FNA和手术的患者细胞和组织病理对比分析得出,前2类总体恶性可能性仅为11.11%,而后4类总体恶性可能性为63.33%,较前者显著升高(P < 0.01)。FNA对恶性或癌前病变诊断的敏感性为82.61%,特异性为74.42%,阳性预测值为63.33%,阴性预测值为88.89%,假阳性率为25.58%,假阴性率为17.39%。结论:TBS类别中AUS-FN-S和M类恶性风险较高,对于指导临床实践有重要价值。

    Abstract:

    Objective:Application of the Bethesda system (TBS)for reporting thyroid cytology in fine needle aspiration(FNA)to improve the capability of cytopathological diagnosis. Methods:Totally 1 705 FNA cytopathological samples were analyzed from May 2011 to Jun 2012. Sixty-six histological pathological samples from these patients were analyzed in the meantime. Results:According to TBS,1 705 FNA cytopathological samples were classified into six categories with 295(17.30%)as nondiagnostic(N),1 291(75.72%)as benign(B),30(1.76%)as atypia of undetermined significance(AUS),19(1.11%)as follicular neoplasm(FN),36(2.11%)as suspicious(S)and 34(1.99%)as malignant(M). Total positive cell rate was 82.70%. It was concluded from the comparison of histopathological and cytopathological slides of 66 patients that the overall occurrence rate of malignancy was 11.11% in former two groups,which was significantly lower than that (63.33%) in latter four groups (P < 0.01). The sensitivity,specificity,positive predictive value,negative predictive value,false positive rate and false negative rate for FNA in differentiation of benign and malignant lesions were calculated as 82.61%,74.42%,63.33%,88.89%,25.58% and 17.39%, respectively. Conclusion:TBS showed great importance in differentiation of benign and malignant thyroid lesions,with high probability of malignancy in AUS,FN,S and M groups.

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蔡 赟,陈欢欢,王知笑,戎 荣,吴云松,崔 岱,蒋 琳,魏 玲,段 宇,杨 涛,刘晓云. Bethesda细胞病理报告系统在甲状腺细针穿刺中的应用[J].南京医科大学学报(自然科学版),2015,(12):1718-1721

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  • 收稿日期:2015-08-13
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  • 在线发布日期: 2016-01-04
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