IMPACT OF FINE NEEDLE ASPIRATION CYTOLOGY ON THE MANAGEMENT OF SOLITARY THYROID-NODULES

被引：8

作者：

NG, EH ^{[1
]}

TAN, SKL ^{[1
]}

NAMBIAR, R ^{[1
]}

机构：

[1] SINGAPORE GEN HOSP,DEPT SURG,OUTRAM RD,SINGAPORE 0316,SINGAPORE

来源：

AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY | 1990年 / 60卷 / 06期

关键词：

cytology; diagnosis; surgery; thyroid neoplasms;

D O I：

10.1111/j.1445-2197.1990.tb07403.x

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

To evaluate the impact of the routine use of fine needle aspiration cytology (FNAC) on the management of solitary thyroid nodules, 102 consecutive patients were assessed in regard to the proportion of patients being subjected to surgery and the corresponding yield of malignancy. This cohort was compared with a historical control where FNAC was not routinely applied as a diagnostic selection criterion. The percentage of patients operated on had decreased from 95% to 60% (p < 0.001) without any significant decrease in the field of malignancy: 18.6% vs 17.6% (p = 0.97). The yield of malignancy of patients operated on had increased from 18.4% to 26.2%. Of those not subjected to surgery, 14 patients or 14% of the original cohort experienced spontaneous complete resolution of their nodules after a mean follow‐up period of 5.5 months (s.d. = 3.5) (non‐resected group). In the retrospective evaluation of diagnostic discriminants to maximize yield of malignancy while minimizing unnecessary surgery for thyroid nodules, the use of combined parameters of clinical suspicion, positive FNAC and age ≥ 50 years detected 100% of malignancies with only 50% of patients requiring surgery. This was superior to other modalities including clinical parameters and expensive investigations of radionuclide scans and ultrasonography. In conclusion, the use of FNAC in the evaluation of solitary thyroid nodules has resulted in a decreased proportion of patients requiring surgery and cost saving while maintaining the yield of malignancy. Copyright © 1990, Wiley Blackwell. All rights reserved

引用

页码：463 / 466

页数：4

共 11 条

[1]

Ng E.H., Thomas A., Nambiar R., Solitary thyroid nodules for surgery — the role of fine needle aspiration biopsy cytology, Ann. Acad. Med. Sing., 17, pp. 15-18, (1988)

[2]

Blum M., Rothschild M., Improved nonoperative diagnosis of the solitary ‘cold’ thyroid nodule: surgical selection based on risk factors and three months of suppression, JAMA, 243, pp. 242-245, (1980)

[3]

Thomas C.G., Buckwalter J.A., Staab E.V., Kerr C.Y., Evaluation of dominant thyroid masses, Ann. Surg., 183, pp. 463-469, (1976)

[4]

Gharib H., James E.M., Charboneau J.W., Naessens J.M., Offord K.P., Colum A.G., Suppressive therapy with levothyroxine for solitary thyroid nodules, New Engl. J. Med., 317, pp. 70-75, (1987)

[5]

Anderson J.B., Webb A.J., Fine needle aspiration biopsy and the diagnosis of thyroid cancer, Brit. J. Surg., 74, pp. 292-296, (1987)

[6]

Suen C.K., Quenville F.N., Fine needle aspiration biopsy of the thyroid gland: a study of 304 cases, J. Clin. Pathol., 36, pp. 1036-1045, (1983)

[7]

Hawkins F., Bellido D., Bernal C., Et al., Fine needle aspiration biopsy in the diagnosis of thyroid cancer and disease, Cancer, 59, pp. 1206-1209, (1987)

[8]

Silverman J.F., West R.L., Larkin E.W., Park H.K., Finley J.L., Swanson M.S., Fore W.W., The role of fine needle aspiration biopsy in the rapid diagnosis and management of thyroid neoplasm, Cancer, 57, pp. 1164-1170, (1986)

[9]

Hamberger B., Gharib H., Melton L.J., Goellner J.R., Zinsmeister A.R., Fine needle aspiration biopsy of thyroid nodules: Impact on thyroid practice and cost of care, Amer. J. Med., 73, pp. 381-384, (1982)

[10]

Reeve T.S., Delbridge L., Sloan D., Crummer P., The impact of fine needle aspiration biopsy on surgery for single thyroid nodules, Med. J. Aust., 145, pp. 308-311, (1986)

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