超声引导下甲状腺结节细针穿刺细胞学检查对不同直径甲状腺结节诊断准确性分析

目的探讨超声引导下甲状腺结节细针穿刺细胞学检查对不同直径甲状腺结节的诊断价值。方法回顾性分析2015年4月至2017年10月137例甲状腺结节患者的临床资料，根据甲状腺结节直径大小将其分为≤5mm组、6~10mm组、11~20mm组、21~30mm组及〉30mm组（依次为A、B、C、D、E组），比较五纽细针穿刺结果与病理学结果的敏感性、特异性、阳性符合率、阴性符合率及诊断符合率等诊断效能指标。结果US—FNAC的总体敏感度、特异度、阳性预测值、阴性预测值和诊断符合率依次为80.31％、8903％、91．387％、81．94％和81．00％。敏感度以C组最高，E组最低，差异有统计学意义（P〈0．05）；五组特异度、阳性预测值及诊断符合率比较，差异无统计学意义（P〉0．05）。结论超声引导下甲状腺结节细针穿刺细胞学检查不仅可作为〉5ram的甲状腺结节术前检查的金标准，对≤5mm甲状腺结节也具有较高的诊断价值，而对于≥30mm的甲状腺结节的诊断价值仍待大样本研究。

Objective To investigate the diagnostic value of ultrasound-guided fine needle aspiration biopsy for thyroid nodules of different diameters. Methods The clinical data of 137 patients with thyroid nodules who were hospitalized in our hospital from April 2015 to October 2017 were retrospectively analyzed. According to the diameter of thyroid nodules, they were divided into five groups including≤5 mm group, 6~10 mm group, 11~20mm group, 21~30mm group and〉30mm group （A, B, C, D, E group ）.The sensitivity, specificity, positive coincidence rate, negative coincidence rate arid diagnostic coincidence of fine needle aspiration and pathology were compared between the five groups. Results The overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic coincidence rate of US-FNAC were 80.31%, 89.03%, 91.387%, 81.94% and 81.00% respectively. The sensitivity was the highest in C group and the lowest in E group with statistical significance （ P〈0.05 ） . The specificity, positive predictive value and diagnostic coincidence rate of the five groups showed no significant difference （ P〉0.05 ） . Conclusion Ultrasound guided fine-needle aspiration cytology can not only be the gold standard for preoperative thyroid nodules above 5mm, but also have a high diagnostic value for thyroid nodules less than 5mm. However, the diagnostic value of ultrasound-guided fine needle aspiration biopsy for thyroid nodules above 30 mm remains to be studied in large samples.