超声引导下细针穿刺抽吸活检诊断甲状腺结节  

Ultrasound-guided fine-needle aspiration biopsy in diagnosis of thyroid nodules

作　　者：倪晓枫[1] 詹维伟[1] 宋琳琳[1] 胡赟赟[1] 姚洁洁[1] 周伟[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院超声科,上海200025

出　　处：《中国介入影像与治疗学》2013年第8期461-464,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨超声引导下细针穿刺抽吸活检(US-FNAB)对不同大小甲状腺结节的诊断价值。方法回顾分析在我院接受US-FNAB检查的689例患者736个甲状腺结节,超声测量结节最大径,并将其分为<5mm、5～10mm、>10mm组;对结节US-FNAB细胞学诊断结果与术后病理结果或随访结果进行比较,分析组间差异。结果 736个结节中,细胞学诊断恶性132个,可疑恶性61个,良性476个,不满意44个,不确定23个。经术后病理或临床随访,恶性结节208个,良性结节528个。恶性结节最大径小于良性结节(P<0.001)。5～10mm组结节的细胞学阳性率和实际恶性率均大于<5mm组及>10mm组(P均<0.05)。US-FNAB细胞学诊断甲状腺良恶性结节的敏感度为87.02%(181/208),特异度97.73%(516/528),准确率94.70%(697/736)。不同大小甲状腺结节US-FNAB检查的诊断敏感度、特异度、阳性预测值、阴性预测值及准确率差异均无统计学意义(P均>0.05)。结论 US-FNAB是判断甲状腺结节性质的有效手段,对不同大小结节都有较高诊断价值。Objective To observe the value of ultrasound-guided fine-needle aspiration biopsy （US-FNAB） in differential diagnosis of thyroid nodules with different sizes. Methods Data were collected from 689 consecutive patients with 736 thyroid nodules who underwent thyroid US-FNAB. The maximum size of nodule was measured by ultrasound, and the nodules were classified as 〈5 mm, 5-10 mm and 〉10 mm groups. The results of cytologic diagnosis were compared with the pathological and clinical follow-up findings, and the differences for nodules with different size were analyzed. Results Among 736 thyroid nodules diagnosed by cytology, 132 were malignant, 61 were suspicious for malignancy, 476 were benign, 44 were unsatisfactory, and 23 were undetermined. Actually there were 208 malignant and 528 benign nodules confirmed by pathological and clinical follow-up results. The malignant nodules were smaller in size than the benign ones （P〈0.001）. Cytologic positive rate and actually malignant rate of the nodules in 5-10 mm group were higher than those in the other two groups. Cytology could efficiently distinguish malignant from benign thyroid nodules, and its sensitivity, specificity and accuracy was 87.02% （181/208）, 97.73% （516/528） and 94.70% （697/736）, respectively. There was no difference of diagnostic value between the three groups （P〉0.05）. Conclusion US-FNAB is useful for diagnosing thyroid nodules, and has similar diagnostic value for nodules with different sizes.

关 键 词：活组织检查  细针吸 甲状腺结节 超声检查 

分 类 号：R581[医药卫生—内分泌] R445.1[医药卫生—内科学]