影响US-FNAC鉴别诊断甲状腺结节良恶性的因素分析  

Analysis of Factors Affecting the Differential Diagnostic Efficacy of US-FNAC for Benign and Malignant Thyroid Nodules

作　　者：杨通辉[1] 吴传美 胡滨[1] 刘启平[1] 王栋华[1] 傅庆印 Yang Tonghui;Wu Chuanmei;Hu Bin;Liu Qiping;Wang Donghua;Fu Qingyin(Department of Ultrasound Medicine,Fudan University Minhang Hospital,Shanghai 201199,China;Department of Medical Imaging,Shanghai International Medical Center,Shanghai 201315,China)

机构地区：[1]复旦大学附属闵行医院超声医学科,上海市201199 [2]上海国际医学中心医学影像科,上海市201315

出　　处：《中国超声医学杂志》2024年第5期493-497,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的分析超声引导下细针穿刺细胞学检查(US-FNAC)鉴别诊断甲状腺结节良恶性效能的影响因素。方法选择520例甲状腺结节患者作为研究对象。以术后病理结果为诊断金标准,所有患者均接受US-FNAC。结果520例甲状腺结节患者手术后病理共检出甲状腺结节520个,其中良性结节225个、恶性结节295个。US-FNAC显示:Ⅰ类结节15个(2.88%)、Ⅱ类结节114个(21.92%)、Ⅲ类结节21个(4.04%)、Ⅳ类结节75个(14.42%)、Ⅴ类结节140个(26.92%)、Ⅵ类结节155个(29.81%),去除Ⅰ和Ⅲ类36个,共计484个结节。US-FNAC诊断准确度为89.46%(433/484),灵敏度为84.85%(168/198),特异度为92.66%(265/286)。US-FNAC与术后病理共有433个结果一致,51个结果不一致。单因素分析显示,吸烟、结节直径、结节血供、结节构成和结节钙化是影响US-FNAC鉴别诊断甲状腺结节良恶性的因素(P<0.05)。多因素Logistic分析显示,结节直径、结节血供、结节构成和结节钙化是影响US-FNAC鉴别诊断甲状腺结节良恶性的独立因素(P<0.05)。结论结节直径、结节血供、结节构成和结节钙化可影响US-FNAC鉴别诊断甲状腺结节良恶性。Objective To analyze the factors affecting the differential diagnostic efficacy of ultrasound-guided fine needle aspiration cytology(US-FNAC)for benign and malignant thyroid nodules.Methods A total of 520 patients with thyroid nodules were selected as subjects.Using the postoperative pathological results as the gold standard,all patients underwent US-FNAC examination.Results The postoperative pathological examination results of 520 patients with thyroid nodules showed a total of 520 thyroid nodules,including 225 benign and 295 malignant nodules.The US-FNAC results showed that there were 15 categoryⅠ(2.88%),114 category Ⅱ(21.92%),21 category Ⅲ(4.04%),75 category Ⅳ(14.42%),140 category Ⅴ(26.92%)and 155 category Ⅵ nodules(29.81%).36 category Ⅰ and Ⅲ nodules were removed,resulting in a total of 484 nodules.The diagnostic accuracy of US-FNAC examination was 89.46%(433/484),sensitivity was 84.85%(168/198),and specificity was 92.66%(265/286).433 cases had consistent results between US-FNAC examination and postoperative pathology,and 51 were inconsistent.Univariate analysis showed that smoking,nodule diameter,nodule blood supply,nodule composition,and nodule calcification were factors that affect the differential diagnostic efficacy of US-FNAC for benign and malignant thyroid nodules(P<0.05).Multivariate Logistic analysis showed that nodule diameter,nodule blood supply,nodule composition,and nodule calcification were independent factors affecting the differential diagnosis of benign and malignant thyroid nodules by US-FNAC(P<0.05).Conclusions The diameter,blood supply,composition and calcification of nodules can affect the ability of US-FNAC to differentiated between benign and malignant thyroid nodules.

关 键 词：超声引导下细针穿刺细胞学检查 甲状腺结节 良性 恶性 影响因素 

分 类 号：R73[医药卫生—肿瘤]