甲状腺癌大小及位置对超声引导下细针抽吸诊断准确率的影响  

Influence of size and depth of thyroid carcinoma on diagnostic accuracy of ultrasound-guided fine-needle aspiration

作　　者：孙永清[1] 刘利平[1] 赵育芳[1] 陈武[1] 杨永生[1] 崔荣荣[1] 刘静静[1] 王潇婧 樊文文[1] 

机构地区：[1]山西医科大学第一医院超声科,山西太原030001

出　　处：《中国介入影像与治疗学》2017年第4期214-217,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：国家人社部留学回国人员科技活动择优资助项目(2016-366);山西省回国留学人员科研资助项目(2014-073)

摘　　要：目的探讨甲状腺癌结节的大小、位置对超声引导下细针抽吸(US-FNA)诊断准确率的影响。方法回顾性分析经手术病理证实的87例甲状腺癌患者共87个结节术前US-FNA的资料,以BSTC分级>Ⅳ级作为US-FNA诊断甲状腺癌标准,根据US-FNA结果与手术病理结果是否相符,将结节分为A组(相符组)和B组(不相符组)。比较两组结节的最大径及结节浅部距甲状腺浅部被膜距离的差异。绘制ROC曲线,获得结节最大径及距甲状腺浅部被膜距离的截断值。结果 US-FNA与手术病理结果相符率为79.31%(69/87)。A组结节最大径为(1.63±0.58)cm,B组为(1.01±0.42)cm;A组结节距甲状腺浅部被膜距离为(4.15±1.83)mm,B组为(7.86±2.08)mm,差异均有统计学意义(P均<0.01)。根据ROC曲线分析,结节最大径的截断值为1.05cm,结节距浅部被膜距离的截断值为6.1mm。结论甲状腺癌的大小及位置均可影响US-FNA诊断准确率。Objective To investigate the influence of size and depth of thyroid carcinoma for diagnostic accuracy of ultrasound-guided fine-needle aspiration （US-FNA）. Methods A retrospective review of clinical and preoperative US-FNA data of 87 malignant thyroid nodules confirmed by surgical pathology from 87 patients was performed. According to the the Bethesda System for Reporting Thyroid Cytopathology （BSTC）, the grade that higher than grade Ⅳ was the cytologic criteria for diagnosis of thyroid carcinoma. According to the cytopathological data of thyroid carcinoma confirmed by surgical pathology, the patients were divided into group A （cytopathological data was same as the surgical pathology result） and group B （cytopathological data was not same as the surgical pathology result）. The longest diameter of malignant thyroid nodules and the distance from the shallow of thyroid nodules to superficial capsule of thyroid gland were analyzed. The ROC analysis was performed to find the optimal cut-off value of the longest diameter of thyroid carcinoma and the distance from the shallow of thyroid carcinoma to superficial capsule of thyroid gland. Results The consistent rate between US-FNA and surgical pathologic results was 79.31% （69/87）. The longest diameter of thyroid carcinoma of group A and group B was （1.63±0.58）cm and （1.01±0.42）cm respectively, which was statistically different （P〈0.01）. The distance from the shallow of thyroid carcinoma to superficial capsule of thyroid gland of group A and group B was （4.15±1.83）mm and （7.86±2.08）mm respectively, which was statistically different （P〈0.01）. According to the ROC analysis results, the optimal cut-off value of the longest diameter of thyroid carcinoma and the distance from the shallow of thyroid carcinoma to superficial capsule of thyroid gland was 1.05 cm and 6.1 mm respectively. Conclusion Diagnosis accuracy of US-FNA could be influenced by size and depth of thyroid carcinoma.

关 键 词：甲状腺肿瘤 超声检查 活组织检查 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]