超声引导细针抽吸活检在甲状腺结节性质鉴别诊断中的意义  

Significance of Ultrasound-Guided Fine Needle Aspiration Biopsy in the Differential Diagnosis of Thyroid Nodule Nature

作　　者：邱建英 QIU Jian-ying(The Third Hospital of Fuqing,Fujian Fuqing 350301)

机构地区：[1]福清市第三医院,福建福清350301

出　　处：《中国医疗器械信息》2023年第1期94-96,共3页China Medical Device Information

摘　　要：目的:探讨超声引导细针抽吸活检(Ultrasound-Guided Fine-Needle Aspiration Biopsy,US-FNAB)在甲状腺结节性质鉴别诊断中的意义。方法:选取2020年7月~2022年7月因可疑恶性甲状腺结节在本院进行超声引导下FNA细胞学检测的甲状腺结节患者628例作为研究对象(共穿刺634个可疑结节),根据最大结节直径大小对其进行分组:4~5mm组、6~10mm组、>10mm组,对比其US-FNAB细胞学结果差异。634个可疑结节中,330个结节进行了手术,317例为US-FNAB明确诊断结节,13例为US-FNAB无法确诊结节,分析手术病理结果,同时比较不同直径可疑恶性甲状腺结节的US-FNAB细胞学结果与术后病理诊断结果差异。结果:4~5mm组、6~10mm组、>10mm组的阳性率逐步增加,组间两两差异均有统计学意义(P<0.05)。4~5mm组、6~10mm组、>10mm组的无法确诊率逐步下降,但是组间差异尚无统计学意义(P>0.05)。317例US-FNAB明确诊断结节的术中病理结果如下:21例为良性结节;288例乳头状癌、5例髓样癌、2例滤泡性肿瘤、1例为肺来源的转移性小细胞癌。13例US-FNAB无法确诊结节的术中病理结果如下:5例为良性结节、8例乳头状癌。US-FNAB细胞图片检测与组织病理诊断的一致性良好Kappa值为0.761(P<0.05),诊断灵敏度为97.37%(296/304)、特异度为92.31%(24/26)、准确度为96.97%(320/330)。结论:US-FNAB在术前甲状腺结节性质鉴别诊断中具有良好的效能,与术中病理结果吻合度高,是一种理想的术前甲状腺结节性质鉴别手段。Objective: To investigate the significance of US-FNAB in the differential diagnosis of thyroid nodule properties under ultrasound guidance. Methods: 628 patients with thyroid nodules who underwent ultrasound-guided FNA cytology detection in our hospital due to suspected malignant thyroid nodules from July 2020 to July 2022 were selected as research objects(a total of 634 suspected nodules were punctured), and grouped according to the maximum nodule diameter: The results of US-FNAB cytology were compared between groups 4-5mm, 6-10mm and >10mm. Among the 634 suspected nodules, 330 nodules underwent surgery, 317 nodules were clearly diagnosed by US-FNAB, and 13 nodules could not be diagnosed by US-FNAB. The surgical pathological results were analyzed, and the differences between the cytological results of US-FNAB and postoperative pathological diagnosis of suspected malignant thyroid nodules with different diameters were compared. Results: The positive rate of 4-5mm group, 6-10mm group and >10mm group increased gradually, and the pairwise differences among groups were statistically significant(P<0.05). The undiagnosed rate of the 4-5mm group, the 6-10mm group and the >10mm group gradually decreased, but there was no statistical significance between the groups(P>0.05). The intraoperative pathological results of 317 US-FNAB nodules were as follows: 21 cases were benign nodules;There were 288 papillary carcinoma, 5 medullary carcinoma, 2 follicular neoplasms, and 1 metastatic small cell carcinoma of lung origin. The intraoperative pathological results of 13 undiagnosed nodules with US-FNAB were as follows: 5 were benign nodules and 8 were papillary carcinoma. The Kappa value of US-FNAB was 0.761(P<0.05), the diagnostic sensitivity was 97.37%(296/304), the specificity was 92.31%(24/26), and the accuracy was 96.97%(320/330). Conclusion: US-FNAB has good efficacy in the differential diagnosis of thyroid nodule properties before surgery, and it is highly consistent with the intraoperative pathological results. It is an ide

关 键 词：超声引导 细针抽吸活检 甲状腺结节 诊断 

分 类 号：TH776[机械工程—仪器科学与技术]