甲状腺结节细针穿刺细胞学检查与TI-RADS的价值分析

Fine needle aspiration cytology and TI-RADS evaluation in thyroid nodules

目的探讨甲状腺结节细针穿刺细胞学检查(FNAC)与甲状腺结节超声评估系统(TI-RADS)的临床应用价值。方法分析475例甲状腺结节的超声声像图特征,通过TI-RADS对甲状腺结节进行分级,与细针穿刺细胞学结果、手术病理及随访结果进行综合比较。结果 FNAC诊断结果与手术病理结果诊断的符合率为90.56%,FNAC诊断甲状腺癌的敏感度为85.7%(18/21),特异度为93.8%(30/32);TI-RADS分级与FNAC对照,诊断符合率为80.2%(381/475),诊断甲状腺癌的敏感度为39.0%(41/105),特异度为91.9%(340/370);TI-RADS与手术病理对照,诊断符合率为90.6%(48/53),诊断甲状腺癌敏感度为85.7%(18/21),特异度为93.8%(30/32)。结论甲状腺结节细针穿刺细胞学检查及超声评估系统对于术前鉴别甲状腺结节的良恶性有重要的临床应用价值。

Objective To evaluate the clinical value of TI-RADS evaluation and fine needle aspiration cytology(FNAC) of thyroid nodules. Methods A retrospective review of 475 patients with thyroid nodule was undertaken, including FNAC, TI-RADS evaluation, follow-up, and surgical decision. Results The accuracy of FNAC was 90.56%, sensitivity was 85.7%, specificity was 93.8% respectively compared with the pathologic diagnosis. The accuracy of TI-RADS evaluation was 80.2%, sensitivity was 39.0%, specificity was 91.9%, respectively compared with FNAC. The accuracy of TI-RADS evaluation was 90.6%, sensitivity was 85.7%, specificity was 93.8% respectively compared with the surgical pathologic diagnosis. Conclusions The TI-RADS evaluation and FNAC of thyroid nodules play important roles for the management of thyroid nodules.