超声引导下细针穿刺细胞学检查鉴别甲状腺结节良恶性的临床价值

Clinical value of ultrasound-guided fine needle aspiration cytology in diagnosis of benign and malignant thyroid nodules

目的:探讨超声引导下细针穿刺细胞学检查(US-FNAC)诊断甲状腺结节性质的临床价值。方法:选择96例甲状腺结节患者,均行超声初筛,并联合US-FNAC检查进行诊断,其中疑似良性结节40例,疑似恶性56例,均行手术治疗。将术后病理学结果作为"金标准",分析超声与US-FNAC诊断甲状腺结节性质的临床价值,对比2种检查方式准确率、灵敏度、特异度、阳性预测值、阴性预测值、假阳性率及假阴性率。结果:96例术后病理学检查显示,结节性甲状腺肿30例(31.25%)、甲状腺腺瘤9例(9.38%)、桥本氏甲状腺炎6例(6.25%)、肉芽肿性甲状腺炎1例(1.04%)、甲状腺乳头癌46例(47.92%)、甲状腺滤泡癌3例(3.12%)、甲状腺髓样癌1例(1.04%)。US-FNAC诊断准确率、灵敏度、特异度分别为94.79%、96.00%、93.47%;超声诊断准确率、灵敏度、特异度分别为85.42%、84.00%、84.78%;US-FNAC诊断价值明显更高(P<0.05)。结论:US-FNAC检查对甲状腺结节具有重要临床应用价值,其诊断准确率高于超声检查,可为疾病定性、制订治疗方案、判断预后等提供参考。

Objective:To study the clinical value of ultrasound-guided fine needle aspiration cytology(US-FNAC)for the diagnosis of thyroid nodules.Methods:96 cases of thyroid nodules were taken as research subjects.All patients underwent ultrasound and combined with US-FNAC examination,among them,thyroid nodules were benign in 40 cases and suspected thyroid nodules were malignant in 56 cases,all were performed surgical treatment.The postoperative pathological results were used as“gold standard”,and the clinical value of ultrasound and US-FNAC examination in the diagnosis of thyroid nodules was analyzed.The accuracy,sensitivity,specificity,positive predictive value,negative predictive value,false positive rate and false negative rate of the two methods were compared.Results:96 cases of postoperative pathological examination showed that 30 cases of nodular goiter(31.25%),9 cases of adenoma(9.38%),6 cases of Hashimoto’s thyroiditis(6.25%),1 case of granulomatoma(1.04%),46 cases of papillary carcinoma(47.92%),3 cases of follicular carcinoma(3.12%)and 1 case of medullary carcinoma(1.04%).The accuracy,sensitivity and specificity of US-FNAC were 94.79%,96.00%and 93.47%respectively,the accuracy,sensitivity and specificity of ultrasonography were 85.42%,84.00%and 84.78%respectively,compared with ultrasonic examination,the diagnostic value of US-FNAC was significantly higher(P<0.05).Conclusions:For patients with thyroid nodules,US-FNAC examination has important clinical value.The accuracy of diagnosis is higher than that of ultrasonic examination.It can provide reference value for disease qualitative,treatment plan,prognosis and so on.For patients with thyroid nodules,it is very important for patients with thyroid nodules.