超声引导下甲状腺穿刺活检技术在甲状腺结节鉴别诊断中的效果评价

Evaluation of ultrasound-guided thyroid biopsy in differential diagnosis of thyroid nodules

目的探讨甲状腺结节鉴别诊断中,超声引导下甲状腺穿刺活检技术的有效性。方法 168例(210个结节)甲状腺结节患者,同时予以基础触诊穿刺活检技术和超声引导下甲状腺穿刺活检技术,观察检测结果并比较两种检测方法的敏感度、特异度、准确率。结果 210个结节中,良性结节136个(64.76%, 136/210),恶性结节74个(35.24%, 74/210),全部结节均成功获取细胞学病理标本。其中基础触诊穿刺活检技术的敏感度为72.97%(54/74),特异度为30.88%(42/136),准确率为45.71%(96/210),其中基础触诊穿刺活检技术评定中,假阴性20例,假阳性94例。超声引导下甲状腺穿刺活检技诊断甲状腺结节性质的敏感度为75.68%(56/74),特异度为88.24%(120/136),准确率为83.81%(176/210)。两种检测方法的敏感度比较,差异无统计学意义(P>0.05);超声引导下甲状腺穿刺活检诊断的特异度、准确率均高于基础触诊穿刺活检技术,差异有统计学意义(P<0.05)。结论超声引导下甲状腺穿刺活检技术应用于甲状腺结节诊断中,有利于鉴别诊断率的提升,同时操作流程安全可行,值得临床进一步推广。

Objective To discuss the effectiveness of ultrasound-guided thyroid biopsy in the differential diagnosis of thyroid nodules. Methods A total of 168 patients(210 nodules) with thyroid nodules received basic palpation biopsy and ultrasound-guided thyroid biopsy at the same time. The detection results were observed, and the sensitivity, specificity and accuracy of the two detection methods were compared. Results Among the 210 nodules studied, there were 136 benign nodules(64.76%, 136/210) and 74 malignant nodules(35.24%, 74/210). Cytopathological specimens were successfully obtained for all nodules. The sensitivity of the basic palpation biopsy was 72.97%(54/74), the specificity was 30.88%(42/136), and the accuracy rate was 45.71%(96/210). Among them, the basic palpation biopsy was evaluated, with 20 false negatives and 94 false positives. The sensitivity of ultrasound-guided thyroid biopsy to diagnose the nature of thyroid nodules was 75.68%(56/74), the specificity was 88.24%(120/136), and the accuracy was 83.81%(176/210). There was no statistically significant difference in the sensitivity between the two methods(P>0.05). The specificity and accuracy of ultrasound-guided thyroid biopsy were higher than that of basic palpation biopsy, and the difference was statistically significant(P<0.05). Conclusion Ultrasound-guided thyroid biopsy is applied to the diagnosis of thyroid nodules, which is conducive to the improvement of differential diagnosis rate. At the same time, the operation process is safe and feasible, which is worthy of further clinical promotion.