高频超声、超声引导下细针穿刺活检(US-FNAB)在甲状腺乳头状癌(PTMC)诊断中的应用价值  

High Frequency Ultrasound,Ultrasound-Guided Fine-needle Aspiration Biopsy(US-FNAB)in the Diagnosis of Papillary Thyroid Carcinoma(PTMC)

作　　者：秦天娇 李明辉 郜晨晖 QIN Tian-jiao;LI Ming-hui;GAO Chen-hui(Department of ultrasound,Gongyi people's Hospital,Gongyi 451200,Henan Province,China;Department of endocrine nephrology,Gongyi people's Hospital,Gongyi 451200,Henan Province,China)

机构地区：[1]巩义市人民医院超声科,河南巩义451200 [2]巩义市人民医院内分泌肾病科,河南巩义451200

出　　处：《罕少疾病杂志》2023年第6期22-24,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的 探讨在甲状腺乳头状癌(PTMC)患者临床诊断中应用高频超声、超声引导下细针穿刺活检(US-FNAB)的价值。方法 对我院2020年4月至2022年4月收治的PTMC患者95例临床资料实施回顾性分析,纳入的95例PTMC患者共152个结节,其中包括99个PTMC结节和53个甲状腺良性结节(BTN),将PTMC结节者纳入a组,BTN结节者纳入b组,所有患者均实施高频超声、US-FNAB检查,应用χ~2检验和Logistic多因素回归分析不同结节呈现出的超声影像学表现、颈部淋巴结是否可以探及等与PTMC之间的关系,并将术后病理学诊断结果 作为金标准,观察高频超声、US-FNAB在PTMC临床诊断中的应用价值,分析并比较不同诊断方式的准确度、灵敏度以及特异度。结果 a组和b组不同超声征像均存在一定差异,差异有统计学意义(P<0.05);高频超声、USFNAB检查与术后病理学诊断结果 之间具有良好的一致性,高频超声诊断Kappa值为0.801,US-FNAB诊断Kappa值为0.892;对152个结节均予以高频超声诊断,经诊断发现其灵敏度、特异度、准确度分别为95.45%、83.18%、91.15%,AUS为0.877;对152个结节中的94个疑似恶性结节予以US-FNAB诊断,经诊断发现其灵敏度、特异度、准确度分别为9 6.03%、93.65%、95.24%,AUS为0.948。结论 对于内部低回声、结节形态不规则且姐姐内存在钙化,加之边缘不清晰等超声影像学征像患者而言,实施高频超声诊断PTMC应用价值较高,虽然高频超声、US-FNAB在PTMC诊断中均具有较高应用价值,但相对US-FNAB而言,高频超声操作简便、成本较低,且无创伤性,对于不存在高危因素的患者而言,可经由高频超声明确诊断。Objective To investigate the value of high-frequency ultrasound,ultrasound-guided fine-needle aspiration biopsy(US-FNA B)in the clinical diagnosis of patients with papillary thyroid carcinoma(PTMC).Methods a retrospective analysis was performed on the clinical data of 95 PTMC patients treated in our hospital from April 2020 to April 2022.A total of 152 nodules,including 99 PTMC nodules and 53 benign thyroid nodules(BTN),were included in the study,those with PTMC nodules were included in the study group A,those with BTN nodules were enrolled in the study group B,all patients were evaluated by high-frequency ultrasound,US-FNAB,We used theχ2 test and logistic multiple regression to analyze the relationship between the sonographic imaging findings presented by different nodules,whether cervical lymph nodes could be explored and others with PTMC,and used the postoperative pathological diagnostic results as the gold standard to observe the utility of high-frequency ultrasound,US-FNA B in the clinical diagnosis of PTMC,and to analyze and compare the accuracy,sensitivity,and specificity of different diagnostic modalities.Results there were some differences in the different sonographic features between groups A and B,and the differences were statistically significant(P<0.05);There was good agreement between high-frequency ultrasound,US-FNA B examination,and postoperative pathological diagnosis,with kappa values of 0.801 for high-frequency ultrasound diagnosis and 0.892 for US-FNAB diagnosis;When all 152 nodules were diagnosed by high-frequency ultrasound,their sensitivity,specificity and accuracy were found to be 95.45%,83.18%,91.15%,respectively,after diagnosis,and the AU C was 0.877;Ninety four suspected malignant nodules from 152 nodules were diagnosed by US-FNA B,which was found to have a sensitivity,specificity,accuracy of 96.03%,93.65%,95.24%,and an aus of 0.948,respectively,after diagnosis.Conclusions the implementation of high-frequency ultrasound in the diagnosis of PTMC in our sister with internal hypoechogenic

关 键 词：高频超声 超声引导下细针穿刺活检 甲状腺乳头状癌 病理学诊断 

分 类 号：R736.1[医药卫生—肿瘤]