超声引导下甲状腺细针穿刺US-FNAC诊断在甲状腺癌中的应用价值

The Application Value of Ultrasound Guided Thyroid Fine Needle Puncture US-FNAC Diagnosis in Thyroid Cancer

目的:探讨超声引导下甲状腺细针穿刺细胞学检查(US-FNAC)在甲状腺癌中的应用价值。方法:选取2020年9月~2023年9月本院联合上级医院收治的80例(95个结节)甲状腺结节患者进行回顾性分析,所有患者一般临床资料、超声诊断资料、US-FNAC检查资料和术后病理资料均完整,以术后病理组织学结果作为“金标准”,分析手术病理和US-FNAC对80例甲状腺结节患者的诊断结果,并分析US-FNAC对甲状腺癌的诊断效能。随后将US-FNAC诊断不准确的11例患者纳入不准确组,将其余患者纳入准确组,分析影响US-FNAC诊断准确率的单因素。结果:手术病理检查结果显示,95个结节中,良性41个,恶性54个,其中甲状腺乳头癌48个,甲状腺滤泡状癌6个。US-FNAC检查95个结节中良性52个,恶性43个,手术病理检查结果与US-FNAC对良恶性的判断对比无差异(P>0.05),80例患者中US-FNAC术后病理结果一致的共有70例,不一致的10例;US-FNAC对甲状腺癌诊断的曲线下面积为0.832,特异度为91.47%,敏感度为73.59%,病理诊断的曲线下面积为0.891,特异度为98.52%,敏感度为90.26%;准确组与不准确组患者结节位置、结节成分、结节直径、血供情况对比差异显著(P<0.05)。结论:与术后病理诊断对比,US-FNAC诊断甲状腺癌的诊断准确率较高,特别是针对结节成分为非囊性、结节直径≥2cm、乏血供的甲状腺结节准确率更高,但是依然存在一定误诊和漏诊情况。

Objective:To explore the application value of ultrasound-guided thyroid fine needle aspiration cytology(US-FNAC)in thyroid adenocarcinoma.Methods:80 cases(95 nodules)of thyroid nodules admitted from September 2020 to September 2023 were selected for retrospective analysis.All the general clinical data,ultrasound diagnosis data,US-FNAC examination data and postoperative pathological data were complete.The postoperative pathological histological results were taken as the“gold standard”,and the diagnostic results of surgical pathology and US-FAC in 80 patients,and the diagnosis of thyroid cancer by US-FNAC was analyzed.Subsequently,11 patients with inaccurate US-FNAC diagnosis were included in the inaccurate group,and the remaining patients were included in the accurate group to analyze the diagnostic accuracy of US-FNAC.Results:The surgical pathological examination results showed that among the 95 nodules,41 were benign and 54 were malignant,including 48 papillary thyroid carcinoma and 6 follicular thyroid carcinoma.US-FNAC examined 52 of the 95 nodules as benign,43 malignant,no difference between US-FNAC(P>0.05).A total of 70 of the 80 patients had consistent pathological results after US-FNAC,10 cases of inconsistency.The area under the curve of US-FNAC for thyroid cancer diagnosis was 0.832,the specificity was 91.47%,a sensitivity of 73.59%,the area under the curve for the pathological diagnosis was 0.891,the specificity was 98.52%,sensitivity was 90.26%.The nodule location,nodule composition,nodule diameter,and blood supply varied significantly between the accurate and inaccurate groups(P<0.05).Conclusion:US-FNAC had a higher diagnostic accuracy for thyroid cancer,especially for thyroid nodules with non cystic components,nodule diameter≥2cm,and lack of blood supply.However,there were still some misdiagnosis and missed diagnosis cases.