超声引导下甲状腺小结节细针穿刺细胞学检查的临床价值

Clinical value of ultrasound-guided fine needle aspiration cytology of thyroid nodules

目的探讨超声引导下细针穿刺细胞学检查(US-FNAC)对甲状腺小结节的临床价值。方法总结最大径≤15 mm的105例患者113个甲状腺结节US-FNAC结果,按结节大小分成≤5 mm、6~10 mm、11~15mm 3组,并将其与手术病理、粗针穿刺组织病理结果及随访1年结果对照,评价US-FNAC诊断甲状腺结节的灵敏度、特异度、符合率、阳性预测值、阴性预测值。结果 113个甲状腺结节,US-FNAC诊断恶性17个、可疑恶性10个、良性65个、滤泡性病变6个、细胞学结果不满意或无诊断15个。US-FNAC诊断甲状腺结节总的灵敏度为82.7%、特异度为95.2%、符合率为91.3%、阳性预测值为88.9%、阴性预测值为92.3%。组间比较差异无统计学意义(P>0.05)。结论 US-FNAC安全可靠,准确性较高,是鉴别甲状腺小结节良恶性的重要方法。

Objective To investigate the clinical value of ultrasound guided fine needle aspiration cytology （US -FNAC） in thyroid nodules. Methods Date of 113 thyroid nodules US- FNAC less than 15mm in 105 patients were divided into three groups according to nodule size 11 - 15 mm,6 - 10 mm and less than 5mm. Compared with the surgical pathology, needle biopsy pathological resuhs and follow - up of one year control, and the sensitivity, specificity, accuracy, positive predictive value, negative predictive value of US - FNAC were evaluated in thyroid nodules. Results 113 cases of thyroid nodules, US - FNAC cytology diagnosis of malignant was in 17 cases, 10 were suspected malignant,benign,follicular lesions were in 6 cases,the results were not satisfied with the cytology or no diagnosis of 15 cases of 65. The sensitivity and specificity of USFNAC in the diagnosis of thyroid nodules were 82.7%, the specificity was 95.2% ,the coincidence rate was 91.3% ,the positive predictive value was 88.9%, and the negative predictive value was 92.3%. Each index of the three groups was not statistically significant （P 〉 0.05 ）. Conclusion Ultrasound guided fine needle aspiration cytology is safe,reliable and accurate. It is an important method to distinguish benign and malignant thyroid nodules.