彩超引导下细针穿刺细胞学与粗针穿刺组织学在甲状腺结节诊断中的应用价值  

Application of ultrasound-guided fine needle aspiration and core needle biopsy in diagnosis of thyroid nodules

作　　者：袁静萍[1] 阎红琳 张世英[1] 刘雯[1] 饶洁[1] 孙圣荣[2] 

机构地区：[1]武汉大学人民医院病理科,430060 [2]武汉大学人民医院甲乳外科,430060

出　　处：《中华内分泌外科杂志》2017年第1期24-28,共5页Chinese Journal of Endocrine Surgery

基　　金：湖北省自然科学基金（2013CFB374）;武汉大学自主科研项目（2042016kf0116）

摘　　要：目的对比细针穿刺细胞学（fine needle aspiration，FNA）与粗针穿刺组织学（core needle biopsy，CNB）检查，探讨其在甲状腺结节诊断中的应用价值。方法选取武汉大学人民医院病理科82例行FNA检查及33例行CNB检查的甲状腺结节患者，以术后病理为金标准，对比细胞学、组织病理学结果与术后病理结果。结果FNA检查结果与CNB的准确性、敏感性、特异性、阳性预测值、阴性预测值、假阳性率（误诊率）、假阴性率（漏诊率）分别为91．5％VS87．9％、93．2％VS87．5％、87．0％VS88．9％、94．8％VS95．5％、83.3％vs72．7％、13．0％ VS 11．1％、6．8％VS12．5％，P均〉O．05，差异均无统计学意义。结论FNA与CNB检查在诊断甲状腺结节良、恶性方面均具有较高的准确性、敏感性、特异性，但FNA更经济、安全、方便，临床应用更广泛．对淋巴瘤或交界性肿瘤，CNB结合免疫组化更占优势。Objective To compare the clinical evaluation in diagnosis of thyroid nodules between fine needle aspiration（FNA） and core needle biopsy（CNB）. Methods 82 cases with thyroid nodules undergoing FNA and 33 cases with thyroid nodules undergoing CNB were selected. Cytology, histopathology, and postoperative results were compared with postoperative pathology as the gold standard. Results The accuracy, sensitivity, specificity, positive predictive value, negative predictive value, false positive rate, false negative rate of FNA and CNB were 91.5% vs 87.9%, 93.2% vs 87.5%, 87.0% vs 88.9%, 94.8% vs 95.5%, 83.3% vs 72.7%, 13.0% vs 11.1%, 6.8% vs 12.5%, respectively. There was no significant difference between FNA and CNB （P〉0.05）. Conclusion Both of FNA and CNB examination show high accuracy, sensitivity and specificity in diagnosis of benign and malignant thyroid nodules, but FNA is more economical, safe, convenient and thus has more extensive clinical application. For lymphoma or borderline tumor, CNB examination combined with immunohistochemistry is of more advantages.

关 键 词：甲状腺结节 细针穿刺细胞学 粗针穿刺组织学 术后病理 

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]