AbstractIntroduction Fine-needle aspiration cytology (FNAC) is an effective tool in the diagnostic work-up of patients with thyroid nodules. The aim of our study was to assess the diagnostic sensitivity of FNAC in thyroid cancer (TC) in Sweden by correlating the findings of preoperative FNAC with those obtained through final histology of the surgical specimen.

摘要简介细针穿刺细胞学（FNAC）是甲状腺结节患者诊断工作的有效工具。我们研究的目的是通过将术前FNAC的发现与通过手术标本的最终组织学获得的结果相关联，评估FNAC在瑞典甲状腺癌（TC）中的诊断敏感性。

Methods A Swedish nationwide cohort of patients having surgery for TC (n = 2519) from the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal surgery between 2004 and 2013 was obtained. Data was validated through scrutinizing patient FNAC and histology reports. Results Among the 2519 cases operated with a final diagnosis of TC, the diagnosis was substantiated and validated through the histology report in 2332 cases (92.6%), included in the present study.

方法获得2004年至2013年间瑞典全国范围内甲状腺，甲状旁腺和肾上腺手术质量登记册中接受TC手术的患者队列（n=2519）。通过仔细检查患者FNAC和组织学报告来验证数据。结果在2519例最终诊断为TC的患者中，2332例（92.6%）通过组织学报告证实并验证了诊断。

Among these, 1679 patients (72%) were female and the median age at TC diagnosis was 52.3 years (range 18-94.6). In 353 cases (15.1%) FNAC was not performed at all; whereas in the remaining 1965 cases, the diagnostic sensitivity of FNAC was 81.6%. In lesions > 1 cm, FNAC diagnostic sensitivity reached 86.5%, whereas in lesions < 1 cm, FNAC yielded a sensitivity of 61.5%.

其中，1679名患者（72%）为女性，TC诊断的中位年龄为52.3岁（范围18-94.6）。在353例（15.1%）中，根本没有进行FNAC；而在其余1965例病例中，FNAC的诊断敏感性为81.6%。在病灶>1 cm时，FNAC诊断敏感性达到86.5%，而在病灶<1 cm时，FNAC的敏感性为61.5%。

Approximately 85% of FNACs (n = 1981/2332) were performed using ultra-sonographic (US) guidance. In TC lesions > 1 cm, the diagnostic sensitivity of US-guided FNAC (n = 1504) was 86.9% as compared to 76.9% in clinically applied FNAC without US utilization (n = 118). Conclusions FNAC is performed in most patients operated for TC in Sweden (85%) and retains its value as a tool in TC diagnostic work-up with an overall sensitivity of 82%, reaching 87% in lesions > 1 cm, that harbor clinically relevant TC..

大约85%的FNAC（1981/2332）是使用超声（US）指导进行的。在TC病变>1 cm时，美国引导的FNAC（n=1504）的诊断敏感性为86.9%，而在没有美国使用的临床应用FNAC中为76.9%（n=118）。结论FNAC在瑞典大多数接受TC手术的患者中进行（85%），并保留其作为TC诊断检查工具的价值，总体敏感性为82%，在具有临床相关TC的病变>1 cm时达到87%。。

IntroductionThyroid cancer (TC)is the most common endocrine malignancy and its incidence is rising at a rate 5–6% per year in the US, as well as internationally in analysis of population-level cancer registries world-wide1,2,3. Although the prognosis of well-differentiated TC (WDTC) cases, which constitute the majority of TCs (94–98%), is generally favorable, disease-specific mortality has been increasing at an average rate of 0.9% per year1,3.

。尽管构成TC大多数（94-98%）的高分化TC（WDTC）病例的预后通常是有利的，但疾病特异性死亡率每年平均以0.9%的速度增加1,3。

Despite that the observed increase in TC incidence appears to be coincident with early detection due to the widespread use of neck ultrasonography and fine-needle aspiration cytology (FNAC), this may not be the only reason for rising incidence rates, as this trend is observed across all different stages, among all ages, genders and ethnic groups4.Malignant follicular cell–derived neoplasms (FDTC) include papillary (PTC), follicular (FTC), and oncocytic (OTC) cell cancers that arise from follicular epithelial cells.

尽管由于颈部超声检查和细针穿刺细胞学检查（FNAC）的广泛使用，观察到的TC发病率增加似乎与早期发现相吻合，但这可能不是发病率上升的唯一原因，因为在所有不同阶段，在所有年龄，性别和种族中都观察到这种趋势。恶性滤泡细胞衍生肿瘤（FDTC）包括滤泡上皮细胞引起的乳头状（PTC），滤泡（FTC）和嗜酸细胞（OTC）细胞癌。

High-grade FDTC now includes both the traditional poorly differentiated carcinoma, as well as high-grade differentiated thyroid carcinomas since both are characterized by increased mitotic activity and tumor necrosis without anaplastic histology and clinically behave in a similar manner5. Anaplastic thyroid carcinoma (ATC) remains the most undifferentiated form with a dismal prognosis.

高级别FDTC现在既包括传统的低分化癌，也包括高级别分化的甲状腺癌，因为两者都以有丝分裂活性增加和肿瘤坏死为特征，没有间变性组织学，临床表现相似5。甲状腺未分化癌（ATC）仍然是最未分化的形式，预后不佳。

Medullary thyroid carcinoma (MTC) arises from parafollicular C-cells which produce calcitonin, and accounts for 5% of thyroid cancers, whereas less than 1–3% of TCs are ATC5,6,7.FNAC is one of the most useful methods for preoperative diagnosis of TC in clinical practice. A combined approach of neck ultrasound and FNAC comprise the main diagnostic workup of thyroid lesions.

甲状腺髓样癌（MTC）起源于产生降钙素的滤泡旁C细胞，占甲状腺癌的5%，而不到1-3%的TC是ATC5,6,7。FNAC是临床实践中术前诊断TC最有用的方法之一。颈部超声和FNAC的联合方法包括甲状腺病变的主要诊断检查。

In recent years, standardization of diagnostic terminology follow.

近年来，诊断术语的标准化随之而来。

Data availability

数据可用性

The registry data underlying this article will be shared upon reasonable request to the corresponding author.

本文的注册数据将在合理要求下共享给通讯作者。

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Download referencesFundingOpen access funding provided by Örebro University. The authors of the study have not received any funding.Author informationAuthors and AffiliationsAnesthesiology Department, Skellefteå Hospital, Skellefteå, SwedenPatrik LindDepartment of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, 70185, SwedenPatrik Lind, Anton Jacobson, Göran Wallin & Kosmas DaskalakisDepartment of Surgery, Skåne University Hospital, Lund, SwedenErik NordenströmDepartment of Clinical Sciences, Lund University, Lund, SwedenErik NordenströmDepartment of Public Health and Clinical Medicine, Skellefteå Research Unit, Umeå University, Umeå, SE-901 81, SwedenLars JohanssonSecond Department of Surgery, Korgialenio-Benakio, Red Cross General Hospital, Athanasaki 11, Athens, 11526, GreeceKosmas DaskalakisAuthorsPatrik LindView author publicationsYou can also search for this author in.

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PubMed Google ScholarContributionsK.D. and G.W. conceived and designed the study. P.L., A.J. and K.D. collected the data, performed analyses, and drafted the manuscript. E.N.,L.J., G.W. and K.D. provided supervision and administrative support. All authors approved the final manuscript text.Corresponding authorCorrespondence to.

PubMed谷歌学术贡献SK。D、 和G.W.构思并设计了这项研究。P、 L.，A.J.和K.D.收集了数据，进行了分析，并起草了手稿。E、 N.，L.J.，G.W.和K.D.提供了监督和行政支持。所有作者都批准了最终稿件文本。对应作者对应。

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Reprints and permissionsAbout this articleCite this articleLind, P., Jacobson, A., Nordenström, E. et al. Diagnostic sensitivity of fine-needle aspiration cytology in thyroid cancer.

转载和许可本文引用本文Lind，P.，Jacobson，A.，Nordenström，E。等人。甲状腺癌细针穿刺细胞学的诊断敏感性。

Sci Rep 14, 24216 (2024). https://doi.org/10.1038/s41598-024-75677-7Download citationReceived: 25 May 2024Accepted: 07 October 2024Published: 16 October 2024DOI: https://doi.org/10.1038/s41598-024-75677-7Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

科学报告1424216（2024）。https://doi.org/10.1038/s41598-024-75677-7Download引文收到日期：2024年5月25日接受日期：2024年10月7日发布日期：2024年10月16日OI：https://doi.org/10.1038/s41598-024-75677-7Share本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

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KeywordsDiagnostic sensitivityFine-needle aspiration cytologyThyroid cancer

关键词细针穿刺细胞学甲状腺癌的诊断敏感性