甲状腺结节大小对超声引导细针抽吸细胞学检查有效率的影响  

Effect on Efficiency of Thyroid Nodules' Size for Ultrasound-Guided Fine-Needle Aspiration Biopsy

作　　者：张琼[1] 彭玉兰[1] 马步云[1] 姜勇[2] 于波洋[1] 张霞[1] 兰琳[1] 

机构地区：[1]四川大学华西医院超声科,四川成都610041 [2]四川大学华西医院病理科,四川成都610041

出　　处：《中国普外基础与临床杂志》2015年第7期832-835,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的 评估甲状腺结节大小对超声引导细针抽吸细胞学检查（US-FNAB）有效率的影响。方法 回顾性分析四川大学华西医院超声科2011年3月至2014年4月期间两位医生行US-FNAB的甲状腺结节共1 142个（医生1和医生2各571个）的资料,根据Bethesda分类标准将细胞学结果分为穿刺有效和穿刺无效两类。根据结节最大径大小分为≤5 mm组、5~10 mm组、10~20 mm组、20~30 mm组及〉30 mm组5组,统计两位医师总的和各自的穿刺有效率,并依据结节组别和穿刺有效率绘制曲线,分别对5组间和两位医师之间的穿刺有效率进行比较。结果 医生1及医生2各自的和两位医师总的穿刺有效率≤5 mm组、5~10 mm组、10~20 mm组、20~30 mm组及〉30 mm组分别为68.42%、83.72%、86.08%、84.62%和73.53%;68.75%、70.53%、81.05%、86.15%和73.91%;以及68.59%、77.53%、83.59%、85.47%和73.75%。两位医生总的穿刺有效率组间两两比较,≤5 mm组低于10~20 mm组（P〈0.001）和20~30 mm组（P=0.001）;医生1和医生2两位医生间5组中穿刺有效率比较仅5~10 mm组的差异有统计学意义（P=0.001）。结论 甲状腺结节大小是影响US-FNAB穿刺有效率的重要因素,最大径≤5 mm和最大径〉30 mm的结节穿刺有效率低,较大结节穿刺有效率低的原因与病变明显的囊性变有关。Objective To assess the effect of the size of thyroid nodules on the diagnostic rate of ultrasound guided aspiration cytology （US-FNAB）. Methods The data of 1 142 （performed by two doctors, 571 each） thyroid nodules between March 2011 and April 2014 in our hospital were retrospectively analyzed. Yields of US-FNAB were divided into two levels of adequacy and inadequacy according to the classification standard of the Bethesda system. The thyroid nodules were classified into five groups according to the largest diameter： ,〈 5 mm group, 5-10 mm group, 10-20 mm group, 20-30 mm group, and 〉30 mm group. According to the grouping of the nodules and the efficiency of US-FNAB drawed curve, the adequacy rates of alone and total of two examiners in each group were analyzed, respectively. Results The adequacy rates of US-FNAB of alone and total of two examiners in ,〈 5 mm group, 5-10 mm group, 10-20 mm group, 20-30 mm group, and 〉30 mm group was 68.42%, 83.72%, 86.08%, 84.62%, and 73.53% （examiner 1）; 68.75%, 70.53%, 81.05%, 86.15%, and 73.91% （examiner 2）; 68.59%, 77.53%, 83.59%, 85.47%, and 73.75% （total of two examiners）, respectively. The total adequacy rate of US-FNAB of two examiners in ,〈 5 mm group was lower than that in 10-20 mm group （P〈0.001） and 20-30 mm group （P=0.001）. The adequacy rate of US-FNAB of examiner 1 in 5-10 mm group was higher than that examiner 2 （P=0.001）. Conclusions The size of thyroid nodules significantly influences the adequatediagnostic rate of US-FNAB. The adequacy rates of US-FNAB of the largest diameter ≤ 5 mm or 〉30 mm were lower. The low adequacy rate of US-FNAB may be associated with cystic degeneration in the larger nodules.

关 键 词：甲状腺结节 细针穿刺抽吸活组织检查 超声检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581[医药卫生—诊断学]