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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/34798完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 張睿詒(Ray-E Chang) | |
| dc.contributor.author | Ping-Hung Huang | en |
| dc.contributor.author | 黃品宏 | zh_TW |
| dc.date.accessioned | 2021-06-13T06:34:49Z | - |
| dc.date.available | 2007-02-08 | |
| dc.date.copyright | 2006-02-08 | |
| dc.date.issued | 2006 | |
| dc.date.submitted | 2006-01-18 | |
| dc.identifier.citation | 參考文獻
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Experience of Thyroid Ultrasonography and Fine-Needle Aspiration Cytology in the Assessment of goiters in General Practice in Taipei, Taiwan. J Intern Med Taiwan 2000; 12:240-244 21. Liao CJ, Hsiao HC, Tu ST, Yeh KT, Chang CC. Comparison between Fine-Needle Aspiration Cytology and Frozen Section Examination in the Diagnosis of Thyroid Lesions. J Taiwan Otolary Head Neck Surg. 2001; 36(6): 347-352 22. Mazzaferri EL: Management of a solitary thyroid nodule. N Engl J Med 1993; 328: 553 23. Molitch ME, Beck JR, Dreisman M, et al. The cold thyroid nodule: An analysis of diagnostic and therapeutic options. Endocrin Rev 1984; 28:145 24. Hamberger B, Gharib H, Melton JL et al: Fine-needle aspiration biopsy of thyroid nodules: Impact on thyroid practice and cost of care. Am J Med 1982; 73:381 25. Gharib H. Changing concepts in the diagnosis and management of thyroid nodules. Endocrinol Metab Clin North Am 1997; 26:777 26. Bruneton JN, Balu-Maestro C, Maray PY, et al. Very high frequency (13 MHz) ultrasonographic examination of the normal neck: Detection of normal lymph nodes and thyroid nodules. J Ultrasound Med 1994; 13:87 27. Lazda EJ, Kocjan G, Sams VR, Wotherspoon AC, Taylor I. Fine needle aspiration (FNA) cytology of the breast: the influence of unsatisfactory samples on patient management. Cytopathology 1996; 7(4): 262-7 28. Dray M, Mayall F, Darlington A. Improved fine needle aspiration (FNA) cytology results with a near patient diagnosis service for breast lesions. Cytopathology 2000; 11:32-7 29. Lu JF, Hsiao WC. Does universal health insurance make health care unaffordable? Lessons from Taiwan. Health Affairs 2003; 22 (3): 77-88 30. Singh N, Ryan D, Berney D, Calaminici M, Sheaff MT, Wells CA. Inadequate rates are lower when FNAC samples are taken by cytopathologists. Cytopathology. 2003, 14 (6): 327-331 31. Vural G, Hagmar B, Lilleng R. A one-year audit of fine needle aspiration cytology of breast lesions. Factors affecting adequacy ad review of delayed carcinoma diagnosis. Acta Cytologica 1995; 39 (6): 1233-1236 32. Saxe A, Philips E, Orfanou P, Husain M. Role of sample adequacy in fine needle aspiration biopsy of palpable breast lesions. Am J Surg 2001; 182(4): 369-371 33. Zarbo RJ, Howanitz PJ, Bachner P. Interinstitutional comparison of performance in breast fine-needle aspiration cytology. Arch Pathol Lab Med 1991; 115:743-750 34. The National Cancer Institute. The uniform approach to breast fine-needle aspiration biopsy—a synopsis: development of proof at a National Cancer Institute-sponsored conference. Bethesda, Md, December 9 and 10, 1996. Acta Cytol 1996; 40:1120-126 35. Geisinger KR, Stanley MW, Raab SS, Silverman JF, Abati A. Modern Cytopathology 2004. Publisher: Churchill Livingstone. P732-733 36. Castro M, Gharib H. Thyroid nodules and cancer. Post-grad Mod 2000; 107:113-124 37. Edmund SC, Barbara SD. Cytology, 2nd edition, Saunders, 2003; p217. 38. Meinkoth JH, Cowell RL. Sample collection and preparation in cytology: increasing diagnostic yield. Veterinary Clinics of North America-Small Animal Practice. 2002 Nov; 32(6): 1187-207 39. Wakasa K. Quality control of cytodiagnosis. Rinsho Byori-Japanese Journal of Clinical Pathology. 2003 Mar; 51(3): 257-60 40. Burch HB, Burman KD, Reed HL, et al. Fine needle aspiration of thyroid nodules. Determinants of insufficiency rate and malignancy yield at thyroidectomy. Acta Cytol 1996; 40 (6): 1176-1183 41. Brown LA, Coghill SB, Powis SA. Audit of diagnostic accuracy of FNA cytology specimens taken by the histopathologists in a symptomatic breast clinic. Cytopathology 1991; 2(1): 1-6 | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/34798 | - |
| dc.description.abstract | 摘 要
目標：我們回顧台灣某醫學中心的甲狀腺和乳房細針穿刺(FNA)抹片，評估其抹片充足性(smear adequacy)。 研究設計：自2004年四月一日至六月三十日共三個月間共收集503例甲狀腺細針穿刺(FNA)抹片和316例乳房細針穿刺(FNA)抹片加以重新檢視。所有這些抹片由一位病理醫師依據下列兩條件標準判定抹片充足性：甲狀腺細針穿刺抹片依據Kini的定義，乳房細針穿刺抹片依據Layfield的定義。所有患者於2005年六月三十日，約一年後搜尋其手術病理組織記錄，將其病理報告和之前的細針穿刺病理診斷記錄比對，並計算細針穿刺細胞學檢查的敏感性(sensitivity)與特異性(specificity)。 結果：甲狀腺和乳房細針穿刺的不充足性抹片(inadequacy smear)比例各佔82.8%和69.5%，且所有假陰性(false negative)的診斷都是由不充足性群體中發現。在不同科別間其抹片的充足性比率呈現統計差異。我們也發現穿刺者(aspirators)執行細針穿刺的頻率愈高，所獲得的抹片的充足性愈高，且發現穿刺者採取的片數愈多，所抽取的抹片充足性也愈高。 結論：太多科別和穿刺者參予甲狀腺細針穿刺檢查，執行穿刺時製作抹片數或穿刺次數少，和某些穿刺者只是偶而執行穿刺是造成不充足抹片比例很高的原因。此外缺乏對穿刺者施以訓練和缺乏操作綱要也是主要的因素。 | zh_TW |
| dc.description.abstract | Abstract
OBJECTIVE: To evaluate the smear adequacy of both thyroid and breast fine needle aspiration (FNA) by reviewing FNA slides at one medical center in Taiwan. STUDY DESIGN: A total of 503 thyroid and 316 breast FNA smears from April 1 to June 30, 2004 were selected and reviewed. A pathologist performed the FNA slide review to determine the smear adequacy according to the criteria of Kini and Layfield. Among the cases studied, those who were operated on before June 30, 2005 were further investigated to analyze the pathology results after operations compared with prior FNA diagnoses. The sensitivity and specificity of FNA examination were then calculated. RESULTS: A high percentage of inadequate smears were observed for both thyroid (82.8%) and breast (69.5%) FNAs, all presenting a false negative diagnosis in the inadequacy group. The smear adequacy rates were significantly different between different specialties. We also found that the higher the frequency of aspirations performed, the higher was the adequacy rate of aspirated smears. Moreover, the greater the number of slides prepared by aspirators, the higher was the smear adequacy rate. CONCLUSION: Many specialties and doctors are involved in thyroid FNA aspiration. A low number of slides prepared and passes taken during FNA aspiration, as well as infrequent and unskilled aspirators, are important factors for the low smear adequacy. Formal training for all aspirators and guidelines for FNA procedures are recommended in the hospital studied. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-13T06:34:49Z (GMT). No. of bitstreams: 1 ntu-95-P92843004-1.pdf: 378922 bytes, checksum: e5685e84781c4ad7a4a3cae7fc9308ea (MD5) Previous issue date: 2006 | en |
| dc.description.tableofcontents | 首頁………………………………………………………………….1
誌謝………………………………………………………………….2 中文摘要…………………………………………………………….3 英文摘要……………………..…………………………………..….4 目錄………………………………………………………………….5 第一章 前言………………………………………………………...6 第二章 國外文獻探討………………………………………………8 第三章 研究設計與方法…………………………………………..16 第四章 研究結果…………………………………………………..18 第五章 討論………………………………………………………..29 第六章 結論與建議………………………………………………..34 參考文獻……………………………………………………………35 | |
| dc.language.iso | zh-TW | |
| dc.subject | 細針穿刺 | zh_TW |
| dc.subject | 抹片充足性 | zh_TW |
| dc.subject | 甲狀腺 | zh_TW |
| dc.subject | 乳房 | zh_TW |
| dc.subject | smear adequacy | en |
| dc.subject | fine needle aspiration | en |
| dc.subject | breast | en |
| dc.subject | thyroid | en |
| dc.title | 甲狀腺與乳房細針穿刺細胞學檢查抹片充足性分析：
以臺灣某醫學中心為例 | zh_TW |
| dc.title | Analysis of the Smear Adequacy of Fine Needle Aspiration Smear in One Medical Center | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 94-1 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 聶鑫(Shin Nieh),高森永(Senyeong Kao) | |
| dc.subject.keyword | 甲狀腺,乳房,細針穿刺,抹片充足性, | zh_TW |
| dc.subject.keyword | thyroid,breast,fine needle aspiration,smear adequacy, | en |
| dc.relation.page | 38 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2006-01-18 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 醫療機構管理研究所 | zh_TW |
| 顯示於系所單位： | 健康政策與管理研究所 | |
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