超声引导组织活检对甲状腺病变的诊断价值

Ultrasound-guided Core-needle Biopsy in the Diagnosis of Thyroid Foci

目的评价超声引导组织活检（core—needle biopsy，CNB）对甲状腺病变的诊断价值。方法选取2004年11月至2011年6月在北京协和医院就诊的117例进行CNB、有完整手术病理或随访资料的甲状腺病变患者，回顾性分析其甲状腺病灶的CNB及病理结果。结果CNB结果显示，117例甲状腺病变中良性85例，恶性28例，可疑恶性2例，取材不满意2例，取材成功率98．3％；弥漫性病变37例，甲状腺结节80例。29例手术患者术后病理显示恶性24例（22例乳头状癌，2例淋巴瘤），其中5例CNB为良性（假阴性）；良性5例。80例甲状腺结节中小于1cm者2例，1—2cm者21例，大于2cm者57例。结论超声引导CNB取材成功率高，安全可靠，可作为超声引导细针抽吸活检（fine needle aspiration，FNA）的有效补充手段，并可用于特殊甲状腺病理类型，如淋巴瘤的首选诊断方式。

Objective To evaluate the efficacy of ultrasound-guided core-needle biopsy （CNB） in diag- nosis of thyroid foci. Methods The ultrasound-guided CNB was performed on 117 thyroid foci in Peking Union Medical College Hospital from November 2004 to June 2011. The diagnostic data of 117 thyroid loci were retrospectively analyzed. Results All patients completed CNB successfully and the satisfaction rate for tissue samples was 98.3%. The CNB pathologic results of 117 patients were as follows： 85 cases were benign, 28 cases were malignant, 2 case were suspected malignant, and 2 cases were inadequate for diagnosis; 37 cases had dif- fuse lesions and 80 cases had nodules. In 29 patients （including 24 cases of malignancy and 5 cases of benign disease） who had undergone surgery, the CNB pathologic results in 5 cases were false negative compared with the pathologic results of surgery. The diameters of thyroid nodules were less than 1 cm in 2 cases, 1 -2 cm in 21 ca- ses, and more than 2 cm in 57 cases. Conclusions Ultrasound-guided CNB is valuable for the differential diagnosis of thyroid loci. It is a supplement to the routine fine needle aspiration and can be used for the diagnosis of special thyroid foci such as the thyroid lymphoma.