超声引导下甲状腺细针穿刺检查在甲状腺肿瘤诊断中的应用价值

Application Value of ultrasound-guided Thyroid fine-needle Aspiration in the Diagnosis of thyroid Tumors

目的分析超声引导甲状腺细针穿刺用于甲状腺肿瘤的诊断价值。方法纳入2022年1月至2022年12月安阳市肿瘤医院收入的甲状腺肿瘤患者共82例(110个结节),均先后予以超声引导甲状腺细针穿刺、无超声引导甲状腺细针穿刺检查,将最终的术后病理结果当作金标准,统计结节有关超声表现,并比较两项检查的诊断效能(准确度、特异度、敏感度、阳性预测值及阴性预测值)。结果82例患者的110个结节,经过手术病理检查显示恶性结节42个,包含乳头状癌28个、滤泡状癌11个、髓样癌2个及未分化癌1个;良性结节68个,包含结节甲状腺肿35个、甲状腺腺瘤20个及桥本甲状腺炎13个。110个结节中,40个形态缺乏规则性,35个边界不清;51个为实性低回声,8个为混合回声,51个为中高回声;42个结节中存在微钙化征象,同时结节为中央型血供。超声引导甲状腺细针穿刺显示恶性结节41个,良性结节69个;无超声引导甲状腺细针穿刺显示恶性结节34个,良性结节76个。超声引导甲状腺细针穿刺的诊断准确度、敏感度以及阴性预测值为97.27%、95.24%、97.10%高于无超声引导甲状腺细针穿刺的83.64%、69.05%、82.89%,差异有统计学意义(P<0.05),两项检查的诊断特异度、阳性预测值相比差异无统计学意义(P>0.05)。结论超声引导甲状腺细针穿刺用于甲状腺肿瘤良恶性诊断不仅操作方便、定位准确,同时诊断准确度以及敏感度较高,对明确肿瘤性质和制定后续治疗方案有着重要价值。

Objective To analyze the diagnostic value of ultrasound-guided fine-needle aspiration for thyroid tumors.Methods A total of 82 thyroid tumor patients(110 nodules)admitted to Anyang Cancer Hospital from January 2022 to December 2022 were included in the study.Both ultrasound-guided and non-ultrasound-guided thyroid fine-needle puncture examinations were performed,and the final postoperative pathological results were used as the gold standard.The ultrasound manifestations related to the nodules were statistically analyzed,and the diagnostic efficacy(accuracy,specificity,sensitivity,positive predictive value,and negative predictive value)of the two examinations were compared.Results Out of 110 nodules in 82 patients,42 were found to be malignant nodules through surgical pathological examination,including 28 papillary carcinoma,11 follicular carcinoma,2 medullary carcinoma,and 1 undifferentiated carcinoma;68 benign nodules,including 35 nodular goiters,20 thyroid adenomas,and 13 Hashimoto's thyroiditis.Out of 110 nodules,40 lacked regularity in morphology and 35 had unclear boundaries;51 are solid low echoes,8 are mixed echoes,and 51 are medium high echoes;There are microcalcifications in 42 nodules,and the nodules have a central blood supply.Ultrasound-guided fine-needle aspiration of the thyroid gland revealed 41 malignant nodules and 69 benign nodules;Non-ultrasound-guided fine-needle aspiration of the thyroid gland revealed 34 malignant nodules and 76 benign nodules.The diagnostic accuracy,sensitivity,and negative predictive values of ultrasound-guided thyroid fine-needle puncture were 97.27%,95.24%,and 97.10%,which were higher than those of ultrasound-guided thyroid fine-needle puncture,which were 83.64%,69.05%,and 82.89%,with statistically significant differences(P<0.05).There was no statistically significant difference in diagnostic specificity and positive predictive values between the two tests(P>0.05).Conclusion Ultrasound-guided fine-needle aspiration for the diagnosis of benign and malignant thyroid tumors is not only convenient to operate and accurately locate,but also has high diagnostic accuracy and sensitivity.It has important value in clarifying the nature of the tumor and formulating subsequent treatment plans.