细针穿刺细胞学诊断准确性在赞比亚的两个三级医院甲状腺结节:横断面研究

Jackson Chipaila, A. Makupe, E. Malyangu, D. Maswahu, J. Kabwe, Etienne Bfk Odimba
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引用次数: 0

摘要

简介:甲状腺结节是非洲常见的外科表现之一,由于其潜在的恶性,引起了极大的关注。赞比亚并没有被排除在这些常见的外科疾病之外。然而,在甲状腺切除术前没有对甲状腺结节进行术前细胞或术中组织诊断,因此很难制定最佳和明确的治疗方案。细针穿刺细胞学(FNAC)在甲状腺肿胀的筛查和管理中起着关键作用。本研究旨在评估FNAC对赞比亚两家三级医院患者甲状腺结节的诊断准确性,以便为在这些机构中使用FNAC进行甲状腺结节的管理奠定基础。目的:评价FNAC在赞比亚大学教学医院(UTH)和恩德拉中心医院(NCH)甲状腺结节诊断中的准确性,并与组织病理学进行比较。方法:于2014年6月至2015年3月在UTH和NCH外科进行前瞻性横断面研究。73例出现可触及甲状腺结节并行甲状腺切除术的患者被纳入研究。将患者的FNAC诊断与甲状腺切除术后的组织病理学结果进行比较。结果:女性占多数(n=67, 91.8%)。患者年龄在18 - 78岁之间。平均年龄44.3岁,40岁为发病高峰。所有患者在入组时均为临床甲状腺功能正常。FNAC调查结果包括23例报告不满意(31.5%);良性29例(39.7%);不典型2例(2.7%);可疑6例(8.2%);恶性13例(17.8%)。所有73例参与者的组织样本均有组织病理学检查结果,其中55例(75.3%)和18例(24.7%)分别为良性和恶性。组织学鉴定的18例恶性肿瘤中,最常见的是滤泡癌(n=9, 50%),其次是乳头状癌(n=6, 33.3%)和未分化癌(n=3, 16.7%)。本研究FNAC的敏感性、特异性、阴性预测值和阳性预测值分别为83.33%、89.09%、94.23%和71.42%,准确率分别为87.67%。结论:本研究中,FNAC对甲状腺结节具有较高的敏感性、特异性、预测值和准确性,可推荐作为术前甲状腺结节筛查的工具。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic Accuracy of Fine needle Aspiration Cytology of Thyroid Nodules at two tertiary Hospitals in Zambia: a cross-sectional study
Introduction: Thyroid nodules are one of the common surgical presentations in Africa and are of great concern because of their potential to be malignant. Zambia is not excluded from these common surgical conditions. However, there are no pre-operative cellular or intra-operative tissue diagnoses of the thyroid nodules done before thyroidectomy making it difficult to plan for an optimal and definitive management. Fine needle aspiration cytology (FNAC) is known to play a pivotal role in the screening and management of thyroid swellings. This study serves to assess the diagnostic accuracy of FNAC on thyroid nodules in patients at two tertiary hospitals in Zambia in order to establish a basis for introducing its use in the management of thyroid nodules at the institutions. Objectives: To evaluate the accuracy of FNAC, as compared to histopathology, in the diagnosis of thyroid nodules at University Teaching Hospital (UTH) and Ndola Central Hospital (NCH) in Zambia. Methods: This was a prospective cross-sectional study conducted in UTH and NCH surgery department from June 2014 to March 2015. Seventy-three patients, who presented with palpable thyroid nodules and underwent thyroidectomy, were enrolled in the study. The FNAC diagnosis of the patients was compared to the histopathology finding following thyroidectomy. Results: Females made up the majority of the patients (n=67, 91.8%). The ages of the patients ranged from 18 to 78 years. The mean age was 44.3 years and the peak age of incidence was in the fourth decade. All patients were clinically euthyroid at the time of enrolment. The FNAC findings included 23 cases reported as unsatisfactory (31.5%); 29 cases benign (39.7%); 2 cases atypical (2.7%); 6 cases suspicious (8.2%); and 13 cases malignant (17.8%). Histopathology findings were available from all 73 tissue samples of participants, of which 55 (75.3%) and 18 (24.7%) were reported as benign and malignant respectively. Of the 18 malignant cases identified by histology, the most common cancer was follicular carcinoma (n=9, 50%), followed by papillary carcinoma (n=6, 33.3%) and undifferentiated carcinoma (n=3, 16.7%). FNAC, in this study, had sensitivity, specificity, negative and positive predictive values, and accuracy of 83.33%, 89.09%, 94.23 and 71.42%, and 87.67% respectively. Conclusion: In this study, FNAC of thyroid nodules had a high sensitivity, specificity, predictive values and accuracy, and can therefore be recommended to be adopted as a pre-operative tool for screening of thyroid nodules.
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