超声引导下细针抽吸活检诊断不同大小甲状腺结节

Ultrasound-guided fine-needle aspiration biopsy in diagnosis of different sizes of thyroid nodules

目的探讨甲状腺结节大小对超声引导下细针抽吸活检(US-FNAB)诊断效能的影响。方法选取接受USFNAB且病理证实为甲状腺结节的患者125例(共143个结节),根据结节最大直径(L)分为3组:A组(L≤10mm),B组(<10mm<L≤15mm),C组(L>15mm)。将US-FNAB细胞学诊断结果与病理结果对比,并进行统计学分析。结果143个结节中US-FNAB细胞学诊断阳性结节94个,阴性结节49个;术后病理诊断恶性结节96个,良性结节47个。良、恶性结节大小差异有统计学意义(P<0.001)。3组敏感度、特异度差异均有统计学意义(P均<0.05),阳性预测值、阴性预测值、假阳性率、假阴性率及准确率差异均无统计学意义(P均>0.05)。与A、B组比较,C组敏感度最低(P<0.05),A、B组敏感度差异无统计学意义(P>0.05)。与B、C组比较,A组特异度最低(P<0.05),B、C组特异度差异无统计学意义(P>0.05)。结论甲状腺结节大小对US-FNAB诊断的效能无影响。

Objective To explore the effect of size of thyroid nodules on the diagnostic efficacy of ultrasound-guided fine- needle aspiration biopsy （US-FNAB）. Methods A total of t25 patients （143 thyroid nodules） accepted US-FNAB and confirmed pathologically were collected. According to the maximum diameter of the thyroid nodules, all nodules were divided into three groups： Group A, L≤10 mm; group B, ≤10 mm〈L≤15 mm; group C, L〉15 mm. The cytologic diagnosis results of US-FNAB were compared with the pathological results, and statistical analysis was performed. Results Among the 143 thyroid nodules, there were 94 positive nodules and 49 negative nodules diagnosed by US-FNAB cytology; there were 96 malignant nodules and 47 benign nodules diagnosed by pathological diagnosis. The size difference between benign and malignant nodules was statistically significant （P〈0. 001）. Among the three groups, there were statistical differences in sensitivity and specificity （both P〈0.05）, and positive predictive value, negative predictive value, false negative rate, false positive rate and accuracy rate had no statistical differences （all P〉0.05）. Compared with group A and group B, the sensitivity in group C was the lowest （P〈0.05）. There was no statistically significant difference between group A and group B （P〉0.05）. Compared with group B and group C, the specificity in group A was the lowest （P〈0.05）. There was no statistically significant difference between group B and group C （P〉0.05）. Conclusion The size of thyroid nodules had no contributing to the diagnostic efficacy of US-FNAB.