超声引导下细针穿刺细胞学检查对TI-RADS 4~5类结节的诊断价值

Diagnostic Value of Ultrasound-Guided Fine Needle Aspiration Biopsy for TI-RADS 4-5 Nodules

目的:研究超声引导下细针穿刺细胞学检查(ultrasound-guided fine needle aspiration biopsy,US-FNAB)对甲状腺TI-RADS 4~5类结节良恶性的诊断价值。方法:回顾性分析2017年1月至2019年3月在大理大学第一附属医院行US-FNAB检查并取得术后病理结果的TI-RADS 4~5类甲状腺结节病人共173例,235个结节。将结节分为以下4组:TI-RADS 4A类、TI-RADS 4B类、TI-RADS 4C类、TI-RADS 5类。将术后病理结果作为金标准,采用χ2检验方法评估US-FNAB结果与术后病理结果的相关性;计算US-FNAB的特异度、灵敏度、阴性预测值、阳性预测值。结果:4组结节US-FNAB结果的准确性与术后病理结果比较,差异无统计学意义(P>0.05)。US-FNAB对TI-RADS 4~5类结节的诊断灵敏度、特异度、阳性预测值、阴性预测值分别为95.74%、91.49%、97.83%、84.31%。结论:US-FNAB对TI-RADS 4~5类甲状腺结节有较高的诊断价值,可以作为术前诊断甲状腺结节性质的有效手段。

Objective:To investigate the diagnostic value of ultrasound-guided fine needle aspiration biopsy(US-FNAB)for benign and malignant thyroid TI-RADS 4-5 types of nodules.Methods:A retrospective analysis was performed on 173 patients with TIRADS category 4-5 thyroid nodule who underwent US-FNAB examination in the First Affiliated Hospital of Dali University from January 2017 to March 2019 and postoperative pathological results were obtained,including 235 nodules.Nodules were divided into the following four groups:TI-RADS 4A,TI-RADS 4B,TI-RADS 4C and TI-RADS 5.Postoperative pathology was used as the gold standard,and the correlation between US-FNAB cytology and postoperative pathology was evaluated byχ2 text.The specificity,sensitivity,negative predictive value and positive predictive value of US-FNAB were calculated.Results:The accuracy of cytological results of nodules US-FNAB in the four groups was compared with the postoperative pathological results,and had no statistical significance(P>0.05).The sensitivity,specificity,positive predictive value and negative predictive value of TI-RADS 4-5 nodules of US-FNAB were 95.74%,91.49%,97.83%and 84.31%,respectively.Conclusion:US-FNAB has high diagnostic value for TI-RADS 4-5 thyroid nodules,which can be used as an effective method for the preoperative diagnosis of thyroid nodules.