甲状腺结节核心穿刺活检-电流法。

Endokrynologia Polska Pub Date : 2023-01-01 Epub Date: 2023-11-23 DOI:10.5603/ep.97053
Emrah Karatay, Mirkhalig Javadov, Hatice Kaya
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引用次数: 0

摘要

超声引导下的细针穿刺活检(FNAB)通常用于术前识别甲状腺结节。虽然FNAB具有很高的诊断准确性和安全性,但由于其对滤泡性病变的诊断准确性相对较低,如非诊断性或不明确意义的异型性(AUS)/不确定意义的滤泡性病变(FLUS), FNAB受到限制。在评估甲状腺结节时,需要额外的诊断测试来克服这些挑战。在引入核心针活检(CNB)后,现在可以用弹簧激活的单作用或双作用针诊断甲状腺结节。CNB有能力通过获得相当大的组织样本来解决FNAB的局限性,该样本具有支持胶囊的组织学结构的更多细节,并且由于缺乏滤泡细胞而带来的非诊断性影响较少。与重复的FNAB相比,CNB已被证明产生较少的模糊结果,如非诊断性或AUS/流感结果。韩国内分泌病理甲状腺CNB工作组于2015年首次发布了“甲状腺核心穿刺活检病理报告”指南。2017年,韩国甲状腺放射学会(KSThR)发布了“甲状腺核心针活检:2016年韩国甲状腺放射学会共识声明和建议”。甲状腺CNB的主要目的是发现需要手术的甲状腺疾病患者,并获得大量低发病率的甲状腺病变。
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Thyroid nodule core needle biopsy - current approach.

Fine needle aspiration biopsy (FNAB) guided by ultrasonography is routinely used to identify thyroid nodules prior to surgery. Although FNAB has great diagnostic accuracy and safety, it is limited by its relatively low diagnostic accuracy in follicular lesions, such as non-diagnostic or atypia of unclear significance (AUS)/follicular lesion of uncertain significance (FLUS). Additional diagnostic tests are required to overcome these challenges in evaluating thyroid nodules. Thyroid nodules can now be diagnosed with spring-activated single- or double-action needles following the introduction of core needle biopsy (CNB). CNB has the ability to address the limitations of FNAB by obtaining a sizeable tissue sample with more details on the histological structure supporting the capsule and fewer non-diagnostic effects brought on by the absence of follicular cells. Compared to repeated FNAB, CNB has been demonstrated to produce fewer ambiguous results, such as non-diagnostic or AUS/FLUS results. The Korean Endocrine Pathology Thyroid CNB Working Group issued its first set of guidelines for "Pathology Reporting of Thyroid Core Needle Biopsy" in 2015. In 2017, the Korean Society of Thyroid Radiology (KSThR) published "Core Needle Biopsy of Thyroid: 2016 Consensus Statement and Recommendations from the Korean Society of Thyroid Radiology". The main objectives of thyroid CNB are to detect individuals with thyroid illness who require surgery and to obtain a significant number of thyroid lesions with low morbidity.

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