超声引导下细针穿刺细胞学检查对长径≤5mm甲状腺微小癌的诊断价值

Ultrasound-guided Fine Needle Aspiration Biopsy for the Diagnosis of Thyroid Microcarcinoma Smaller Than or Equal to 5 mm

目的 探讨超声引导下细针穿刺细胞学检查（ultrasound—guidedfineneedleaspirationbiopsy，US—FNAB）对长径≤5mm甲状腺微小癌的诊断价值。方法回顾性分析我院2013年6月～2015年3月超声引导下细针穿刺294例甲状腺结节患者的298个最大径线≤5mm的结节，分析穿刺细胞学诊断资料与手术病理及临床随访结果。结果298个结节中，经细胞学诊断恶性结节172个，良性结节126个；经术后病理学或临床随访证实恶性结节173个，良性结节125个。细针穿刺细胞学检查的敏感度为96．0％（166／173），特异度为95．2％（119／125），准确率为95．6％（285／298），阳性预测值为96．5％（166／172），阴性预测值为94．4％（119／126）。结论US．FNAB对长径≤5mm的甲状腺微小癌有很高的应用价值。

Objective To investigate the value of ultrasound-guided fine needle aspiration biopsy （FNAB） for the diagnosis of thyroid microcarcinoma smaller than or equal to 5 mm in diameter. Methods A retrospective review was conducted on 298 thyroid nodules ≤5 mm in 294 patients who underwent ultrasound-guided FNAB in our hospital. The diagnostic data obtained from FNAB were compared with those confirmed by surgical pathology and clinical follow-ups. Results Among these 298 thyroid nodules, ultrasoundguided FNAB showed that 172 were malignant and 126 were benign, while surgical pathology and clinical follow-ups confirmed that there were 173 malignant nodules and 125 benign nodules. For ultrasound-guided FNAB, the sensitivity was 96.0% （166/173） , the specificity was 95.2% （119/125 ） , the accuracy was 95.6% （285/298） , the positive predictive value was 96.5 % （166/172） , and the negative predictive value was 94.4% （ 119/126）. Conclusion Ultrasound-guided FNAB of thyroid microcarcinoma ≤ 5 mm in diameter is an effective diagnostic procedure.