2018-08-012024-05-17https://scholars.lib.ntu.edu.tw/handle/123456789/670401摘要：甲狀腺腫是最常見的甲狀腺疾病，評估結節性甲狀腺腫之甲狀腺細針抽吸細胞學檢查是個已建立診斷價值的檢驗。臨床醫師執行細針抽吸後，製作傳統細胞抹片再送去實驗室染色，然而傳統細胞抹片有以下的缺點，如抹片血液過多、因抹片乾燥而固定不良造成不易判讀及黏液與發炎細胞的干擾。液基細胞學在25年以前就被用於處理婦科檢體，然後應用於非婦科的檢體，如甲狀腺細針抽吸檢體。液基製備的抹片和傳統抹片不一樣，細針抽吸的檢體先被放入含有甲醇為基底的保存劑溶液，送去實驗室後，用此含保存劑的溶液製作薄層細胞抹片以進行巴氏染色。因為保存良好，抹片上細胞顯現良好的形態學特徵以供判讀，他們也均勻散佈在乾淨的背景中，沒有細胞碎片，黏液或血液的干擾。細胞醫檢師和細胞病理醫師可以容易地篩選或查驗抹片。 電腦細胞學分析是一種電腦輔助分析的技術，從細胞抹片取得的數位影像上的細胞，經由選取的參數可進行量的評估。最近幾年我們應用電腦細胞分析來預測甲狀腺乳突癌病患的預後，利用電腦分析比較存活超過20年和因甲狀腺乳突癌而過世的病患其細胞抹片上形態學或色彩的差異。細胞形態跟色彩特徵的量化有潛力發展為預測甲狀腺癌病患長期存活的預後。 在此前瞻性的研究，我們預計收集1,200名病患的甲狀腺細針抽吸檢體，去比較液基細胞學和傳統細胞學診斷的準確度。為了評估巴氏染色抹片電腦輔助診斷的準確率，我們將發展電腦輔助診斷的軟體，來比較液基細胞學和傳統細胞學評估巴氏染色細胞抹片的診斷表現。<br> Abstract: Goiter is the most common thyroid disease. Fine needle aspiration (FNA) of the thyroid is a well-established diagnostic test for the evaluation of thyroid nodules. Traditionally, conventional smears (CSs) are prepared for staining after FNA. However, they are suffered from the problems, namely, heavy bloody smears, poor fixation smears resulted from air-drying artefact, and obscuring mucus and inflammatory cells. Liquid-based cytology (LBC) has been introduced since 25 years ago. First it was for the processing gynecological specimens and then was applied in non-gynecological specimens such as thyroid FNA materials. Liquid-based preparation (LBP), as opposed to CS, FNA specimen is submerged in a single vial of methanol-based preservative solution and then thin layer smears are prepared for the following Pap. stain in the laboratory. Because of better preservation, the cells display better morphological features on the smears for interpretation. They are also evenly distributed in the clean background without interference of debris, mucus or blood. Both cytotechnologists and cytopathologists can easily screen or check the smears. Computerized cytologic analysis is a computer-aided image analysis technique that enables quantitative estimation of selected parameters in the cells on digital images of the cytologic smear. In recent years, we have developed the application of computerized cytological analysis to predict the papillary thyroid carcinoma (PTC) patients who can survive for more than 20 years or not since cytodiagnosis. The visualization and quantification of cytologic morphology and chromatic features have the potential of being developed as a computer analysis tool for predicting the long-term survival of PTC. In this prospective study, we intend to collect 1,200 patients’ thyroid FNA specimens to compare diagnostic accuracy of LBC and CSC. In order to evaluate computer-aided diagnosis using papanicolaou-stained smear. We intend to develop a computer-aided diagnosis software and compare diagnostic performance between LBC and CSC using Pap.-stained smears.甲狀腺腫是最常見的甲狀腺疾病，評估結節性甲狀腺腫之甲狀腺細針抽吸細胞學檢查是個已建立診斷價值的檢驗。臨床醫師執行細針抽吸後，製作傳統細胞抹片再送去實驗室染色，然而傳統細胞抹片有以下的缺點，如抹片血液過多、因抹片乾燥而固定不良造成不易判讀及黏液與發炎細胞的干擾。液基細胞學在25年以前就被用於處理婦科檢體，然後應用於非婦科的檢體，如甲狀腺細針抽吸檢體。液基製備的抹片和傳統抹片不一樣，細針抽吸的檢體先被放入含有甲醇為基底的保存劑溶液，送去實驗室後，用此含保存劑的溶液製作薄層細胞抹片以進行巴氏染色。因為保存良好，抹片上細胞顯現良好的形態學特徵以供判讀，他們也均勻散佈在乾淨的背景中，沒有細胞碎片，黏液或血液的干擾。細胞醫檢師和細胞病理醫師可以容易地篩選或查驗抹片。 電腦細胞學分析是一種電腦輔助分析的技術，從細胞抹片取得的數位影像上的細胞，經由選取的參數可進行量的評估。最近幾年我們應用電腦細胞分析來預測甲狀腺乳突癌病患的預後，利用電腦分析比較存活超過20年和因甲狀腺乳突癌而過世的病患其細胞抹片上形態學或色彩的差異。細胞形態跟色彩特徵的量化有潛力發展為預測甲狀腺癌病患長期存活的預後。 在此前瞻性的研究，我們預計收集1,200名病患的甲狀腺細針抽吸檢體，去比較液基細胞學和傳統細胞學診斷的準確度。為了評估巴氏染色抹片電腦輔助診斷的準確率，我們將發展電腦輔助診斷的軟體，來比較液基細胞學和傳統細胞學評估巴氏染色細胞抹片的診斷表現。Goiter is the most common thyroid disease. Fine needle aspiration (FNA) of the thyroid is a well-established diagnostic test for the evaluation of thyroid nodules. Traditionally, conventional smears (CSs) are prepared for staining after FNA. However, they are suffered from the problems, namely, heavy bloody smears, poor fixation smears resulted from air-drying artefact, and obscuring mucus and inflammatory cells. Liquid-based cytology (LBC) has been introduced since 25 years ago. First it was for the processing gynecological specimens and then was applied in non-gynecological specimens such as thyroid FNA materials. Liquid-based preparation (LBP), as opposed to CS, FNA specimen is submerged in a single vial of methanol-based preservative solution and then thin layer smears are prepared for the following Pap. stain in the laboratory. Because of better preservation, the cells display better morphological features on the smears for interpretation. They are also evenly distributed in the clean background without interference of debris, mucus or blood. Both cytotechnologists and cytopathologists can easily screen or check the smears. Computerized cytologic analysis is a computer-aided image analysis technique that enables quantitative estimation of selected parameters in the cells on digital images of the cytologic smear. In recent years, we have developed the application of computerized cytological analysis to predict the papillary thyroid carcinoma (PTC) patients who can survive for more than 20 years or not since cytodiagnosis. The visualization and quantification of cytologic morphology and chromatic features have the potential of being developed as a computer analysis tool for predicting the long-term survival of PTC. In this prospective study, we intend to collect 1,200 patients’ thyroid FNA specimens to compare diagnostic accuracy of LBC and CSC. In order to evaluate computer-aided diagnosis using papanicolaou-stained smear. We intend to develop a computer-aided diagnosis software and compare diagnostic performance between LBC and CSC using Pap.-stained smears.甲狀腺抽吸細胞學液基細胞學傳統抹片細胞學電腦輔助診斷Thyroid fine needle aspiration cytologyliquid-based cytologyconventioal smear cytologycomputer-aided diagnosis