超声引导下甲状腺细针穿刺抽吸对甲状腺结节良恶性鉴别诊断的应用价值

Ultrasound-guided fine needle aspiration in differential diagnosis of benign and malignant thyroid nodules

目的探究超声引导下甲状腺细针穿刺抽吸对患者甲状腺结节良恶性鉴别诊断的应用价值。方法回顾性分析2016年9月—2018年2月本院收治的45例甲状腺结节患者共计52个甲状腺结节。所有患者均行FNA进行活检术,术中采取标本进行病理检查。以术后病理结果作为最终标准,来计算FNAC:方法的敏感性、特异性、阳性预测值、阴性预测值及准确性。比较大小结节、良恶性结节及不同操作医师样本取样满意率。结果 FNAC的检测敏感性(73.9%)、特异性(94.2%)、阳性预测值(94.4%)、阴性预测值(76.9%)、准确性(86.4%)。小结节(57.6%)与大结节(87.5%)阴性预测值,差异有统计学意义(P<0.05),其余无明显差异。在大小结节、良恶性及不同操作者的情况下,结节取材不满意率差异无统计学意义(P>0.05)。结论超声引导下甲状腺细针穿刺抽吸对甲状腺不同大小的结节良恶性鉴别诊断的敏感性、特异性均很高,值得临床推广。

Objective To investigate the value of ultrasound-guided fine needle aspiration in the differential diagnosis of benign and malignant thyroid nodules.Methods A total of 52 thyroid nodules in 45 patients with thyroid nodules admitted to our hospital from September 2016 to February 2018 were retrospectively analyzed.All patients were implemented with FNAC and biopsy.Specimens were taken for pathological examination.Postoperative pathological test results as the final standard,to calculate the sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of the FNAC assay.The sampling satisfaction of large and small nodules,benign and malignant nodules sample,and different operating physicians were compared.Results The detection sensitivity,specificity,positive predictive value,negative predictive value and accuracy of FNAC were 73.9%,94.4%,94.2%,76.9%and 86.4%,respectively.There was a significant difference in the negative predictive value between small nodules(57.6%)and large nodules(87.5%)(P<0.05),however,the rest had no significant difference.In the circumstances of large and small nodules,benign and malignant nodules samples and different operating physicians,there was no significant difference in unsatisfactory rates of nodules drawn(P>0.05).Conclusions The sensitivity and specificity of ultrasound-guided fine needle aspiration in the differential diagnosis of benign and malignant nodules of different sizes are quite high and worthy of clinical promotion.