US-FNA诊断甲状腺良恶性结节的临床价值研究

Clinical value of US-FNA in diagnosis of benign and malignant thyroid nodules

目的:探讨超声引导下细针穿刺(ultrasound-guided fine needle aspiration,US-FNA)诊断甲状腺良恶性结节的临床价值。方法:选择2019年7月—2021年7月期间大理大学第一附属医院超声医学科接收的甲状腺结节患者105例共138个结节作为研究资料,经超声诊断可疑为恶性结节,并实施US-FNA诊断,以手术病理证实甲状腺良性结节61个,恶性结节77个,评价US-FNA诊断的准确率、敏感度、特异度,并比较大结节和小结节的取材情况和诊断结果。结果:105例患者发生出血1例,不良反应发生率为0.95%,取材失败率2.86%。US-FNA诊断甲状腺恶性结节的敏感度为93.51%,特异度为88.52%,准确率为91.30%,阳性预测值为94.74%,阴性预测值为93.10%,诊断大结节恶性效能分别为89.29%、88.24%、88.89%、96.15%、83.33%,诊断小结节恶性效能分别为95.92%、88.64%、91.40%、94.00%、95.12%,比较差异均无统计学意义(P>0.05)。结论:甲状腺良恶性结节鉴别诊断中采取US-FNA具有较高的准确性,而且不受结节大小的影响,具有操作简单、敏感度及特异度高优势,具有较高的临床应用价值。

Objective To explore the clinical value of ultrasound-guided fine needle aspiration(US-FNA)in the diagnosis of benign and malignant thyroid nodules.Methods From July 2019 to July 2021,138 thyroid nodules of 105 patients received from the First Affiliated Hospital of Dali University were selected as the research data.The suspected malignant nodules were diagnosed by ultrasound,and US-FNA diagnosis was performed.61 benign thyroid nodules and 77 malignant nodules were confirmed by surgical pathology.The accuracy,sensitivity and specificity of US-FNA were evaluated,and the sampling and diagnosis results of large and small nodules were compared.Results Bleeding occurred in 1 of 105 patients,the incidence of adverse reactions was 0.95%,and the failure rate of sampling was 2.86%.The sensitivity,specificity,accuracy of US-FNA in the diagnosis of thyroid malignant nodules were 93.51%,88.52%,91.30%,94.74%,93.10%;That of the diagnostic efficacy of large nodules was 89.29%,88.24%,88.89%,96.15%and 83.33%respectively,and that of small nodules was 95.92%,88.64%,91.40%,94.00%and 95.12%respectively,there was no significant difference between the two groups(P>0.05).Conclusion US-FNA has high accuracy in the differential diagnosis of benign and malignant thyroid nodules,and is not affected by the size of nodules.It has advantages of simple operation,high sensitivity and specificity,and high clinical application value.