甲状腺结节细针穿刺活检标本满意度的影响因素分析

Analysis of influencing factors on satisfaction of fine needle biopsy specimens of thy roid nodules

目的探讨甲状腺结节细针穿刺活检(FNA)标本满意度的影响因素。方法回顾性分析2016年9月至2019年1月东莞市滨海湾中心医院收治的88例甲状腺结节患者(95个结节)的超声图像。依据Bethesda细胞学分类标准将BethesdaⅠ类的细胞学标本定义为不满意,BethesdaⅡ~Ⅵ类的细胞学标本定义为满意。评估甲状腺结节位置、成分、内部回声、形态、纵横比、钙化、血供模式及美国放射学会甲状腺影像报告和数据系统(ACR TI-RADS)分类对甲状腺结节FNA标本满意率影响的差异,再将其中差异有统计学意义的影响因素进行logistic回归分析。结果本研究总体标本满意率为84.2%(80/95)。单因素分析结果显示,甲状腺结节的位置、纵横比及ACR TI-RADS分类是影响甲状腺结节FNA标本满意率的相关因素,差异具有统计学意义(P<0.05)。Logistic回归分析显示结节纵横比是影响甲状腺结节FNA标本满意率的独立影响因素(OR=13.5,P=0.02)。结论甲状腺结节FNA标本满意率的主要影响因素是结节纵横比。优化穿刺路线可能有助于降低甲状腺结节FNA标本的不满意率。

Objective To explore the infuencing factors of satisfaction with thyroid nodule fine needle biopsy(FNA).Methods The ultrasonie images of 88 patients with thyroid nodules(95 nodules)in Dongguan Binhai Bay Central Hospital from September 2016 to January 2019 were analyzed retrospective-ly.According to Bethesda cytological elassifieation standard,Bethesda class I cytological specimens were defined as unsatisfactory,and Bethesda class II-VI cytological specimens were defined as satisfactory.The thyroid nodule location,composition,internal echo,morphology,aspeet ratio,caleification,blood supply mode and American College of Radiology Thy roid Imaging Reporting and Data System(ACR TI-RADS)clas-sification on the satisfaction rate of thy roid nodule FNA samples were evaluated,and then the meaningful in-fluencing factors were analyzed by logistic regression.Results The overall satisfaction of the sample in this study was 84.2%(80/95).The resuls of univariate analysis showed that the location,aspect ratio and ACR TI-RADS classification of thyroid nodules were the related factors afcting the satisfaction of FNA specimens of thyroid nodules.with statistically significant difference(P<0.05).Logistic regression analy-sis showed that the aspect ratio of thy roid nodules was an independent factor affeting the satisfaction of FNA specimens of thyroid nodules(OR=13.5.P=0.02).Conclusions The main factor affecting the satisfac-tion rate of FNA specimens of thyroid nodules may lie in the characteristics of the aspeet ratio of the nodules themselves.Optimizing the puncture route may help to reduce the dissatisfaction rate of FNA specimens of thyroid nodules.