超声引导下细针穿刺抽吸活检鉴别诊断甲状腺结节良恶性的价值

Value of ultrasound-guided fine-needle aspiration biopsy in differential diagnosis of benign and malignant thyroid nodules

目的研究超声引导下细针穿刺抽吸活检(US-FNAB)鉴别诊断甲状腺结节(TN)良恶性的价值。方法选择2021年5月至2023年5月于河南省濮阳市人民医院治疗的118例(142个结节)TN患者。所有TN患者均进行US-FNAB检查。统计手术病理结果及US-FNAB结果,以手术病理结果作为金标准,计算US-FNAB诊断TN良恶性敏感度、特异度、准确度及US-FNAB诊断TN良恶性结果与病理结果的一致性。结果118例(142个结节)TN患者经手术病理结果证实恶性结节85个,良性结节57个;118例(142个结节)TN患者中US-FNAB细胞学取材成功率为97.2%(138/142);US-FNAB诊断恶性结节86个,良性结节56个,误诊6个,漏诊5个;US-FNAB诊断TN良恶性的敏感度为94.1%(80/85)、特异度为89.5%(51/57)、准确度为92.3%(131/142)、阳性预测值为93.0%(80/86)、阴性预测值为91.1%(51/56);US-FNAB诊断TN良恶性结果与病理结果一致性好(Kappa=0.838,P<0.05)。结论US-FNAB取材成功率较高,US-FNAB鉴别诊断TN良恶性结果与病理结果一致性好,US-FNAB用于TN性质的诊断效能较高。

Objective To study the value of ultrasound-guided fine needle aspiration biopsy(US-FNAB)for the differential diagnosis of benign and malignant thyroid nodules(TN).Methods One hundred and eighteen patients(142 nodules)with TN treated at our hospital from May 2021 to May 2023 were selected.All TN patients underwent US-FNAB examination.Surgical pathological results and US-FNAB results were counted,using surgical pathological results as the gold standard,to calculate the sensitivity,specificity,accuracy,and consistency between US-FNAB diagnosis of benign and malignant TN and pathological results.Results Among 118 TN patients(142 nodules),surgical and pathological results confirmed 85 malignant nodules and 57 benign nodules.The success rate of US-FNAB cytology sampling in 118 TN patients(142 nodules)was 97.2%(138/142).Using surgical pathological examination as the gold standard,US-FNAB diagnosed 86 malignant nodules,56 benign nodules,6 misdiagnoses,and 5 missed diagnoses.The sensitivity of US-FNAB in diagnosing TN benign and malignant was 94.1%(80/85),the specificity was 89.5%(51/57),the accuracy was 92.2%(131/142),the positive predictive value was 93.0%(80/86),and the negative predictive value was 91.1%(51/56).The US-FNAB diagnosis of TN showed excellent consistency with pathological results(Kappa=0.838,P<0.05).Conclusion The success rate of US-FNAB sampling was high,and the differential diagnosis of benign and malignant TN by US-FNAB was highly consistent with pathological results.US-FNAB had high sensitivity,specificity,accuracy,positive predictive value,and negative predictive value in the diagnosis of TN properties.