激素剂量在通过 FNA 评估宫颈病变中的作用：对 762 个病例的描述性分析

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics Pub Date : 2024-11-28 DOI:10.1016/j.clinsp.2024.100539

Arthur Henrique Cunha-Volpato , Carlos Izaias Sartorão Neto , Luiz Fernando Ferraz da Silva , Paulo Campos Carneiro

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引用次数: 0

摘要

引言 20世纪90年代开始在细针抽吸活检（FNA）针头冲洗液中使用激素剂量（HD），最初的目的是测量甲状腺球蛋白（TG）。甲状腺宫颈外病变中的甲状腺球蛋白浓度升高提示甲状腺分化良好癌（WDTC）转移。多年来，HD 不断发展，纳入了降钙素（CT）和副甲状腺激素（PTH），提高了不同临床情况下的灵敏度和特异性。结果根据 FNA 细胞学和 PTH HD 的综合结果可以确定病变的组织发生机制，因此 PTH 对确定所有区域的甲状旁腺来源都很有用，而甲状腺球蛋白（TG）和 PTH 的结合则可以帮助了解疑难病例的细胞来源。甲状腺球蛋白（TG）的剂量可提高检测分化良好的甲状腺癌的准确性。对于甲状腺切除术后的着床病变，TG剂量有助于确定非甲状腺/甲状旁腺病变。通过将 HD 与细胞学、超声和临床数据相结合，临床医生可以提高 FNA 诊断各种宫颈病变的准确性和特异性，最终改善患者护理和管理。

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The role of hormone dosages in the assessment of cervical lesions by FNA: A descriptive analysis of 762 cases

Introduction

The use of Hormone Dosage (HD) in Fine Needle Aspiration Biopsy (FNA) needle washout fluid, introduced in the 1990s, initially aimed at measuring Thyroglobulin (TG). Elevated TG concentration in an extrathyroidal cervical lesion suggests metastases of Well-Differentiated Thyroid Carcinomas (WDTC). Over the years, HD has evolved to incorporate Calcitonin (CT) and Parathormone (PTH), improving sensitivity and specificity in diverse clinical scenarios. Despite varying cutoffs in the literature, existing data underscore significant advancements in diagnostic accuracy.

Methods

This paper presents a case series of 762 cervical lesions with FNA cytology and HD in different cervical regions.

Results

It was possible to establish the histogenesis of the lesion based on a combination of the FNA cytology and PTH HD findings, so PTH was useful to determine parathyroid origin in all regions, Thyroglobulin (TG) and PTH together provide insights on cell origin in difficult cases. Thyroglobulin (TG) dosage enhances the accuracy of detecting well-differentiated thyroid carcinomas. In post-thyroidectomy by bed lesions, dosages help to determine non-thyroid/parathyroid lesions.

Discussion

The case series and review underscore the valuable contribution of HD in fine-needle aspiration for the evaluation of cervical lesions. By integrating HD with cytological, ultrasound, and clinical data, clinicians can enhance the accuracy and specificity of FNA in diagnosing various cervical lesions, ultimately improving patient care and management.

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来源期刊

Clinics 医学-医学：内科

CiteScore

4.10

自引率

3.70%

发文量

129

审稿时长

52 days

期刊介绍： CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.