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目的评估甲状腺结节诊断中甲状腺细胞病理学Bethesda报告系统(TBSRTC)的临床应用及其特点。方法回顾性分析南京中医药大学附属中西医结合医院2009年5月至2013年12月行超声引导甲状腺细针穿刺(UG-FNA)的连续1667例涂片资料,并采用TBSRTC的6类分类诊断术语诊断。连续记录199例临床资料及其215个穿刺结节的大小。结果 1667例标本中,无法诊断有478例(28.7%),良性病变931例(55.8%),意义不明确的细胞非典型性病变114例(6.8%),可疑滤泡性肿瘤32例(1.9%),可疑恶性肿瘤69例(4.1%),恶性肿瘤31例(2.6%)。对记录大小的215个结节穿刺结果进行分析发现,最大直径小于0.5 cm的结节无法诊断率最高(64.3%),随着体积增大,良性结节的比例也显著增加,恶性结节的最大直径多见于0.5~2.0 cm。结论 TBSRTC有助于进一步规范临床甲状腺病理报告和甲状腺结节的处理。
Objective To evaluate the clinical application and characteristics of thyroid cytopathology Bethesda’s reporting system (TBSRTC) in the diagnosis of thyroid nodules. Methods A retrospective analysis of 1667 smears of ultrasound-guided thyroid needle aspiration (UG-FNA) from May 2009 to December 2013 in the Affiliated Hospital of Traditional Chinese Medicine and Western Medicine, Nanjing University of Traditional Chinese Medicine was retrospectively analyzed and classified into 6 categories by TBSRTC Terminology diagnosis. Continuous records of 199 cases of clinical data and the size of 215 puncture nodules. Results Of the 1667 specimens, 478 (28.7%) were undetectable, 931 (55.8%) were benign lesions, 114 (6.8%) were atypical nonspecific lesions, and 32 %), Suspicious malignant tumors in 69 cases (4.1%), and malignant tumors in 31 cases (2.6%). Analysis of 215 nodules puncturing results showed that the nodules with the largest diameter less than 0.5 cm had the highest diagnostic yield (64.3%), the proportion of benign nodules also increased significantly with the increase of volume, The most common diameter of 0.5 to 2.0 cm. Conclusion TBSRTC helps to further standardize the clinical thyroid pathology report and the treatment of thyroid nodules.