细针穿刺联合超声量化评分对甲状腺结节良恶性质的诊断效能分析

Analysis on the diagnostic efficacy of fine needle aspiration combined with ultrasound quantitative scoring for benign and malignant thyroid nodules

目的:探讨细针穿刺联合超声量化评分对甲状腺结节良恶性质的诊断效能。方法:选取医院收治的204例甲状腺结节患者,依据手术病理结果将其分为良性结节组(72例)和恶性结节组(132例)。两组均行细针穿刺与超声检查,在超声检查下进行超声量化评分。以手术病理结果为“金标准”,对比超声量化评分、细针穿刺单独应用与联合应用对甲状腺结节良恶性质的诊断效能。结果:恶性结节组的超声量化评分值、细针穿刺分级值均高于良性结节组,差异有统计学意义(t=6.935,t=7.925;P<0.05)。超声量化评分诊断出阳性结节144例,阴性结节60例,其对甲状腺恶性结节的诊断灵敏度、特异度、阳性预测值及阴性预测值分别为77.27%、54.17%、77.08%和65.00%。细针穿刺诊断阳性结节132例,阴性结节72例,其对甲状腺恶性结节诊断的灵敏度、特异度、阳性预测值及阴性预测值分别为79.55%、62.50%、79.55%和62.50%。细针穿刺联合超声量化评分对甲状腺恶性结节的诊断灵敏度、特异度、阳性预测值及阴性预测值分别为86.36%、76.00%、88.37%和76.00%。细针穿刺、超声量化评分及两项联合检测的受试者工作特征(ROC)曲线下面积(AUC)值分别为0.884、0.871和0.942。结论:细针穿刺联合超声量化评分对甲状腺结节有较高的诊断灵敏度和特异度,其诊断效能显著,并能指导部分结节穿刺后的临床治疗。

Objective:To investigate the diagnostic efficacy of fine needle aspiration combined with ultrasound quantitative scoring for the benign and malignant thyroid nodules.Methods:204 patients with thyroid nodules who admitted to hospital were selected,and they were divided into benign nodule group(72 cases) and malignant nodule group(132 cases) according to the pathological results of surgery.Both two groups underwent fine needle aspiration and ultrasonography,and underwent ultrasound quantification scoring under ultrasonography.The pathological results of surgery were used as the gold standard,and then the diagnostic efficacies of ultrasound quantitative scoring,the single and combined application of fine needle aspiration for the benign and malignant thyroid nodules were further compared.Results:The values of ultrasound quantification scoring and the fine needle aspiration grading in malignant nodule group were significantly higher than those in benign nodule group(t=6.935,t=7.925,P<0.05).Ultrasound quantitative scores confirmed 144 cases were positive nodules and 60 cases were negative nodules,and the diagnostic sensitivity,specificity,positive predictive value and negative predictive value of that were 77.27%,54.17%,77.08% and 65.00% for thyroid malignant nodules,respectively.Fine needle aspiration confirmed 132 cases were positive nodules and 72 cases were negative nodules,and the diagnostic sensitivity,specificity,positive predictive value and negative predictive value of that were 79.55%,62.50%,79.55% and 62.50% for thyroid malignant nodules,respectively.In addition,the diagnostic sensitivity,specificity,positive predictive value and negative predictive value of fine needle aspiration combined with ultrasound quantitative scoring were 86.36%,76.00%,88.37% and 76.00% for thyroid malignant nodules,respectively.The area under curve(AUC) values of receiver operating characteristic(ROC) curve of fine needle aspiration,ultrasound quantitative scoring and the combinations of them were 0.884,0.871 and 0.942,respectively.Conclusion:The diagnostic sensitivity and specificity of fine needle aspiration combined with ultrasound quantitative scoring are higher for thyroid nodules.The diagnostic efficiency of is significant and it can guide the clinical treatment for partial nodule after puncture.