优化甲状腺髓样癌超声与细针穿刺细胞学诊断标准  

Optimizing the Diagnostic Criteria of Ultrasound and Fine Needle Aspiration Cytology for Medullary Thyroid Carcinoma

作　　者：张婷 王玉环[1] ZHANG Ting;WANG Yuhuan(Department of Pathology,The First Affiliated Hospital of Xiamen University,Xiamen Fujian 361003,China)

机构地区：[1]厦门大学附属第一医院病理科,福建厦门361003

出　　处：《中国卫生标准管理》2022年第8期78-81,共4页China Health Standard Management

摘　　要：目的探讨优化细针穿刺细胞学(fine-needle aspiration cytology,FNAC)与超声诊断标准在甲状腺髓样癌(medullary carcinoma of thyroid gland,MTC)诊断方面的应用价值。方法收集29例术后病理确诊的MTC病例,回顾性分析:(1)采用美国放射学会(American Society of Radiology,ACR)2017版超声甲状腺影像报告和数据系统(thyroid imaging reporting and data system,TI-RADS)与优化的TI-RADS分类标准进行评分的得分结果与诊断准确性;(2)FNAC涂片采用Bethesda报告系统标准与优化标准的诊断准确性。结果(1)MTC结节超声检查按优化的TI-RADS分类标准评分结果为(9.07±1.87)分,优于按ACR 2017版TI-RADS分类标准的(6.52±1.65)分,差异有统计学意义(P<0.05);(2)MTC结节在优化的TI-RADS标准下超声诊断敏感度为89.7%,优于ACR 2017版TI-RADS标准下的62.1%,差异有统计学意义(P<0.05);(3)MTC结节FNAC涂片按优化的标准诊断敏感度为93.1%,优于按Bethesda报告系统标准的58.6%,差异有统计学意义(P<0.01)。结论优化超声与FNAC诊断标准可提高MTC术前的诊断准确性,对制定MTC患者的手术方式和避免再次手术以及改善其预后均有重大临床的意义。Objective To explore the application value of optimized ultrasound and fine-needle aspiration cytology(FNAC)diagnostic criteria in medullary carcinoma of thyroid gland(MTC)diagnosis.Methods A total of 29 cases of MTC confirmed by pathology after operation were collected and analyzed retrospectively:(1)the score results and diagnostic accuracy of ultrasound using American Society of Radiology(ACR)2017 TI-RADS and optimized TI-RADS classification standard;(2)the diagnostic accuracy of FNAC smear using Bethesda report system standard and optimized standard.Results(1)The score of MTC nodule was(9.07±1.87)points according to the optimized TI-RADS classification standard,which was better than(6.52±1.65)points according to the ACR 2017 TI-RADS classification standard(P<0.05).(2)The diagnostic sensitivity of MTC nodule was 89.7%under the optimized TI-RADS standard,which was better than 62.1%under the ACR 2017 TI-RADS standard(P<0.05).(3)The sensitivity of FNAC smear was 93.1%,which was better than 58.6%of Bethesda report system(P<0.01).Conclusion The optimization of ultrasound and FNAC diagnostic criteria can improve the accuracy of preoperative diagnosis of MTC,which is of great clinical significance for the formulation of operation mode,avoidance of reoperation and improvement of prognosis of MTC patients.

关 键 词：甲状腺髓样癌 超声 甲状腺影像报告和数据系统 细针穿刺细胞学 Bethesda报告系统 优化 诊断标准 

分 类 号：R445[医药卫生—影像医学与核医学]