细针抽吸细胞学检查假阴性的甲状腺结节超声特征分析  

Analysis of ultrasonographic features of thyroid nodules with false negative fine-needle aspiration cytology

作　　者：余小情 傅晓红[1] 胡姣姣 何洁[1] 余炜烇 沈燕[1] YU Xiaoqing;FU Xiaohong;HU Jiaojiao;HE Jie;YU Weiquan;SHEN Yan(Department of Ultrasound,GongLi Hospital,Pudong New Area,Shanghai 200135,China)

机构地区：[1]上海市浦东新区公利医院超声科,上海200135

出　　处：《肿瘤影像学》2023年第6期521-524,共4页Oncoradiology

基　　金：浦东新区卫生健康委员会卫生计生科研项目面上项目(PW2022A-67);浦东新区卫生健康委员会学科建设重点专科项目(PWZzK2022-18)。

摘　　要：目的:探讨超声引导下细针抽吸细胞学检查(fine-needle aspiration cytology,FNAC)假阴性的甲状腺结节相关超声特征。方法:回顾并分析2017年1月—2019年5月行FNAC且结果为阴性的310例甲状腺结节超声表现,最终将88例经术后病理学检查证实的患者纳入研究。超声特征包括结节的位置、最大径、纵横比、回声水平、边缘、周边声晕、后方回声衰减、内部囊性变、钙化类型及血供程度,将上述指标与术后病理学检查结果比较。所有患者分为真阴性组及假阴性组,采用单因素及多因素分析FNAC假阴性与甲状腺结节超声特征的相关性。结果:88例FNAC结果为良性的患者中24例经术后病理学检查证实为甲状腺乳头状癌,1例为甲状腺滤泡状癌。结节的超声特征中,单因素分析显示,结节纵横比>1、非低回声、边缘不规则、内部囊性变、钙化及富血供,易造成FNAC假阴性,与真阴性组比较差异有统计学意义(P<0.05),结节的最大径、位置、周边声晕、后方回声衰减差异无统计学意义(P>0.05)。Logistic回归分析显示,结节纵横比>1、钙化及富血供两组差异有统计学意义。结论:当甲状腺结节具有纵横比>1、钙化及富血供等超声特征表现,结节FNAC易出现假阴性结果。Objective:To investigate the ultrasonographic characteristics of thyroid nodules with false negative results of ultrasound-guided fine-needle aspiration cytology(FNAC).Methods:A total of 310 patients with negative results who underwent FNAC from January 2017 to May 2019 were enrolled.88 patients confirmed by pathology were included in this study.Ultrasound features included position,the maximum diameter,A/T,echo level,margin,halo,posterior acoustic attenuation,internal cystic changes,calcification and blood supply.The above indicators were compared with pathology results.The patients were divided into two groups:false negative and true negative groups.Single factor analysis and logistic regression analysis were used to evaluate the correlation between false negative results of FNAC and ultrasonographic characteristics of thyroid nodules.Results:A total of 88 cases with the false negative proportion was including 24 cases of papillary thyroid carcinoma,1 case of follicular thyroid carcinoma.Single factor analysis showed that false-negative results were increased in the nodes with A/T>1,non-hypoechoic,irregular margin,internal cystic changes,calcification and increased blood supply,the difference between the two groups was statistically significant compared with the true negative group(P<0.05).However,the maximum diameter,position,halo and posterior acoustic attenuation were not associated with the false negative results(P>0.05).Logistic regression analysis showed that A/T>1,calcification,and high blood supply were associated with the false negative results of FNAC.Conclusion:When thyroid nodules with sonographic characteristics such as aspect ratio>1,calcification and rich blood supply were prone to false-negative results during FNAC.

关 键 词：甲状腺结节 细针抽吸细胞学检查 假阴性 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]