超声引导下甲状腺结节细针穿刺结果无法诊断的影响因素分析

Analysis of influencing factors of failure of ultrasound-guided fine needle aspiration for diagnosis of thyroid nodules

目的探讨超声引导下甲状腺细针穿刺细胞学检查(FNAB)结果无法诊断的影响因素。方法136例符合术前细针穿刺条件的甲状腺结节患者,均行超声引导下甲状腺细针穿刺细胞学检查。观察分析检查结果中无法诊断和有诊断情况,并比较无法诊断和有诊断患者的结节直径、部位、结构。结果136例患者经超声引导下甲状腺细针穿刺细胞学检查显示:有诊断患者115例,无法诊断患者21例。无法诊断患者中结节直径<5 mm占比为42.9%,结节直径5~10 mm占比为33.3%,结节直径>10 mm占比为23.8%;有诊断患者中结节直径<5 mm占比为18.3%,结节直径5~10 mm占比为54.8%,结节直径>10 mm占比为27.0%。无法诊断患者结节部位前侧占比为33.3%,背侧占比为66.7%;有诊断患者结节部位前侧占比为67.8%,背侧占比为32.2%。无法诊断患者中实性结节占比为14.3%,囊性结节占比为61.9%,囊实性结节占比为23.8%;有诊断患者中实性结节占比为28.7%,囊性结节占比为21.7%,囊实性结节占比为49.6%。无法诊断患者结节直径<5 mm占比、结节部位为背侧占比、囊实性结节占比均高于有诊断患者,差异具有统计学意义(P<0.05)。结论甲状腺结节的大小、位置和结构性质是影响结节能否穿刺成功的重要客观因素。

Objective To discuss the influencing factors of failure of ultrasound-guided fine-needle aspiration biopsy(FNAB)diagnosis.Methods A total of 136 patients with thyroid nodules who met the conditions of preoperative fine needle aspiration were underwent ultrasound-guided fine-needle aspiration biopsy.Cases with or without diagnosis results were observed and analyzed.The diameter,location and structure of nodules were compared between those who could not be diagnosed and those who had diagnosis.Results The results of ultrasound-guided thyroid fine needle aspiration biopsy in 136 patients showed that 115 patients were diagnosed and 21 patients could not be diagnosed.Among patients who could not be diagnosed,nodule diameter<5 mm accounted for 42.9%,nodule diameter 5-10 mm accounted for 33.3%,and nodular diameter>10 mm accounted for 23.8%.Among patients with diagnosis,nodule diameter<5 mm accounted for 18.3%,nodule diameter 5-10 mm accounted for 54.8%,and nodular diameter>10 mm accounted for 27.0%.The proportion of nodules at the anterior side was 33.3%among patients who could not be diagnosed,and the dorsal side was 66.7%.The proportion of nodules at the anterior side was 67.8%among patients with diagnosis,and the dorsal side was 32.2%.Among patients who could not be diagnosed,the proportion of solid nodule,cystic nodule and cystic solid nodule were 14.3%,61.9%and 23.8%respectively.Among patients with diagnosis,the proportion of solid nodules,cystic nodules and cystic solid nodules were 28.7%,21.7%and 49.6%respectively.The proportion of nodule diameter<5 mm,nodule at the dorsal side and cystic nodules among patients who could not be diagnosed were higher than patients with diagnosis,and their difference was statistically significant(P<0.05).Conclusion The size,location and structural properties of thyroid nodules are important objective factors affecting the success of nodule puncture.