甲状腺结节非负压细针穿刺细胞学检查标本充分性分析  

Analysis of specimen adequacy of fine needle non-aspiration cytology in thyroid nodules

作　　者：骆鹏飞[1] 穆夏黎 焦大海[1] 王冬 张培新[1] 马玲[1] 王坤 马伟 Luo Pengfei;Mu Xiali;Jiao Dahai;Wang Dong;Zhang Peixin;Ma Ling;Wang Kun;Ma Wei(Department of Thyroid and Breast Surgery,Fuyang People’s Hospital,Fuyang 236000,China;Department of Internal Medicine,Fuyang People’s Hospital,Fuyang 236000,China;Department of Ultrasonography,Fuyang People’s Hospital,Fuyang 236000,China)

机构地区：[1]阜阳市人民医院甲状腺乳腺外科,阜阳236000 [2]阜阳市人民医院内科,阜阳236000 [3]阜阳市人民医院超声科,阜阳236000

出　　处：《中华内分泌外科杂志》2022年第1期70-74,共5页Chinese Journal of Endocrine Surgery

基　　金：阜阳市自筹经费科技计划项目 (FK202081015)。

摘　　要：目的探讨甲状腺结节非负压细针穿刺细胞学检查(fine-needle aspiration cytology,FNAC)不充分标本的发生情况及其可能的影响因素。方法回顾性分析1571例1638个甲状腺结节FNAC患者临床资料,据FNAC标本细胞充分与否将标本分为充分组和不充分组。使用单因素分析及Logistic回归分析不充分标本的影响因素。结果1638份FNAC标本中301份标本细胞不充分,不充分标本占比为18.4%。Logistic回归分析显示操作者经验(P=0.00)、结节≤0.5 cm(P=0.00)、蛋壳样钙化(P=0.00)、囊性(P=0.00)为整体标本充分性的影响因素,排除经验的影响,结节≤0.5 cm(P=0.00)、蛋壳样钙化(P=0.00)、囊性(P=0.00)为经验丰富操作者标本充分性的影响因素。结论操作者经验、结节≤0.5 cm、纯囊性结节、伴有蛋壳样钙化是非负压FNAC标本充分性的影响因素,对经验丰富的操作者,制约其标本充分性的是FNAC技术本身的局限性,对于经验不丰富操作者,制约标本充分性的主要是操作经验。Objective To investigate the occurrence of inadequate specimens of thyroid nodule fine needle non-aspiration cytology and its possible influencing factors.Methods Clinical data of 1571 patients with FNAC of 1638 thyroid nodules were analyzed retrospectively,according to whether the FNAC specimen were adequate or not,all cases were divided into adequate group and inadequate group.The related influencing factors on inadequate specimen were analyzed by univariate analysis and multivariate logistic regression.Results Inadequate specimens occurred in 301 of 1638(18.4%)nodules.Logistic regression analysis showed that the influencing factors of overall specimen adequacy included operator experience(P=0.00),nodules size≤0.5 cm(P=0.00),eggshell calcification(P=0.00),and cystic(P=0.00).Excluding the impact of operator experience,the influencing factors of specimen adequacy included nodules size≤0.5 cm(P=0.00),eggshell calcification(P=0.00),and cystic(P=0.00).Conclusions Operator experience,nodules size≤0.5 cm,cystic,together with eggshell calcification are influencing factors of specimen adequacy of fine needle non-aspiration cytology in thyroid nodules.For experienced operators,what restrict specimen adequacy is the limitation of FNAC technique.For inexperienced operators,what restrict specimen adequacy is operator’s experience.

关 键 词：甲状腺结节 活组织检查 细针 标本充分性 

分 类 号：R653[医药卫生—外科学] R736.1[医药卫生—临床医学]