穿刺针型号及甲状腺结节超声特征对超声引导下细针穿刺活检标本取材满意率的影响

Influence of puncture needle type and ultrasonic characteristics of thyroid nodules on the sampling satisfaction rate of ultrasound-guided fine needle biopsy specimen

目的:探讨不同穿刺针型号及结节超声特征对甲状腺结节细针穿刺标本取材满意率的影响。方法:纳入2020年8月—2022年8月在南京同仁医院行细针穿刺活检的185例甲状腺结节患者(185个结节),所有结节均接受23G和25G超声引导下细针穿刺抽吸活组织检查(ultrasound-guided fine needle aspiration biopsy,US-FNAB)。根据其超声特征(结节大小、粗大钙化、血供、回声)进行分组,穿刺标本依据Bethesda甲状腺细胞病理学报告系统(the Bethesda system for reporting thyroid cytopa-thology,TBSRTC)诊断分类分为取材满意和不满意两类,分析穿刺针型号及结节的超声特征对穿刺标本取材满意率的影响。结果:23G组和25G组总体标本取材满意率无统计学差异(85.4%vs.88.1%,P=0.443)。根据结节最大径分3组,≤0.5 cm组标本取材满意率低于0.5~1.0 cm、≥1.0 cm两组(P<0.05)。根据结节钙化分为粗大钙化组和其他组,23G细针在粗大钙化组中的标本取材满意率高于25G细针(76.5%vs.52.9%,P<0.05),在其他组两种细针的标本取材满意率无统计学差异。根据血供情况分为血供丰富组和乏血供组,25G细针在血供丰富组标本取材满意率高于23G细针(83.3%vs.61.9%,P<0.05),在乏血供组两种细针的标本取材满意率无统计学差异。根据结节回声分为低回声组、等回声组、高回声组,23G与25G细针在不同回声组之间比较,差异无统计学意义(P>0.05)。结论:甲状腺结节较小(最大径≤0.5 cm)、伴有粗大钙化或血供丰富均会影响标本的取材满意率。

Objective:To investigate the influence of different puncture needle types and ultrasonic characteristics of thyroid nodules on the sampling satisfaction rate of ultrasound-guided fine needle biopsy specimen.Methods:A total of 185 patients with thyroid nodules(185 nodules)who underwent fine-needle aspiration biopsy in Nanjing Tongren Hospital between August 2020 and August 2022 were included.All nodules received 23 G and 25 G ultrasound guided fine-needle aspiration biopsy.According to nodular ultrasonic characteristics(nodule size,coarse calcification,blood supply,echo),puncture specimens were classified into satisfactory and unsatisfactory categories according to the Bethesda system for reporting thyroid cytopathology.The influence of puncture needle types and nodular ultrasonic characteristics on the sampling satisfaction rate were evaluated.Results:There was no statistical difference in the overall sampling satisfaction rate between the 23 G group and the 25 G group(85.4%vs.88.1%,P=0.443).According to the maximum diameter,the nodules were divided into three groups.The satisfactory rate of specimen collection in the group≤0.5 cm was lower than those in the group 0.5-1.0 cm and group≥1.0 cm(P<0.05).According to nodule calcification,the patients were divided into coarse calcification group and other groups.The satisfaction rate of 23 G fine needle in the coarse calcification group was higher than that of 25 G fine needle(76.5%vs.52.9%,P<0.05).There was no statistical difference in the satisfaction rate of the two kinds of fine needle in other groups.According to the blood supply,the nodules were divided into the blood supply rich group and the blood supply deficient group.The satisfaction rate of 25 G fine needle in the blood supply rich group was higher than that of 23 G fine needle(83.3%vs.61.9%,P<0.05).There was no statistical difference in the sample collection satisfaction rate between 23 G and 25 G fine needles in the blood supply deficient group.The nodules were divided into hypoechoic,isoechoic and hyperechoic groups according to their echo.There was no statistical difference in sampling satisfaction rate between 23 G and 25 G fine needles in different echo groups(P≥0.05).Conclusion:Small thyroid nodule(maximum diameter≤0.5 cm),accompanied by coarse calcification or rich blood supply will affect the sampling satisfaction rate.