摘要
目的:比较细针穿刺活检(US-FNA)与粗针穿刺活检(US-CNB)在不同大小甲状腺结节诊断中的价值。方法:选取2020年3月至2022年3月我院收治的甲状腺结节患者106例,将患者根据结节最大直径进行分组,患者结节最大直径≤10mm纳入A组,最大直径>10mm纳入B组,所有患者均进行US-FNA与US-CNB检查,并于术后进行病理诊断,以术后病理诊断为金标准,探究US-FNA与US-CNB在不同大小甲状腺结节诊断中的价值。结果:A组患者中恶性结节37例(2例滤泡癌,28例乳头状癌,3例甲状腺淋巴瘤,4例甲状腺肉瘤),良性结节13例(2例结节性甲状腺肿伴滤泡性腺瘤结节,11例结节性甲状腺肿);B组患者中恶性结节39例(3例滤泡癌,31例乳头状癌,2例甲状腺淋巴瘤,3例甲状腺肉瘤),良性结节17例(4例结节性甲状腺肿伴滤泡性腺瘤结节,13例结节性甲状腺肿)。A组患者经US-CNB及US-FNA诊断甲状腺结节的准确率分别为80.00%、82.00%,敏感度分别为86.49%、83.78%,特异度分别为61.54%、76.92%,阳性预测值为86.49%、91.18%,阴性预测值分别为61.54%、62.50%,卡帕一致性检验分析卡帕值分别为0.480(P=0.001),0.565(P<0.001)。B组患者经US-FNA及US-CNB诊断甲状腺结节的准确率分别为73.21%、78.57%,敏感度分别为76.92%、79.49%,特异度分别为64.71%、76.47%,阳性预测值为83.33%、88.57%,阴性预测值分别为55.00%、61.90%,卡帕一致性检验分析,卡帕值分别为0.525(P<0.001),0.397(P=0.003)。结论:当患者的甲状腺结节≤10mm时,选择US-FNA进行诊断,准确度较高;当其>10mm时,应选择US-CNB进行诊断。
Objective:To explore the value comparison of fine needle biopsy(US-FNA)and crude needle biopsy(US-CNB)in the diagnosis of different size thyroid nodules.Methods:A total of 106 patients with thyroid nodules admitted to our hospital from March 2020 to March 2022 were selected and grouped according to the maximum diameter of the nodule,Patients with a nodule diameter less than 10mm were included in group A and the maximum diameter more then 10mm was included in Group B.All patients were examined for US-FNA and US-CNB,and postoperative pathological diagnosis was performed.Postoperative pathological diagnosis was taken as the gold standard to explore the value of US-FNA and US-CNB in the diagnosis of thyroid nodules of different sizes.Results:There were 37 malignant nodules(2 follicular carcinomas,28 papillary carcinomas,3 thyroid lymphomas,and 4 thyroid sarcomas)and 13 benign nodules(2 nodular goiters with follicular adenomatous nodules,and 11 nodular goiters)in patients in group A.There were 39 malignant nodules(3 follicular carcinoma,31 papillary carcinoma,2 thyroid lymphoma,3 thyroid sarcoma)and 17 benign nodules(4 nodular goiter with follicular adenoma nodules,13 nodular goiter)in patients in group B.The accuracy of diagnosis of thyroid nodules by US-CNB and US-FNA in patients in group A was 80.00%and 82.00%,sensitivity was 86.49%and 83.78%,specificity was 61.54%and 76.92%,positive predictive value was 86.49%and 91.18%,negative predictive value was 61.54%and 62.50%,and kappa Consistency test analyzed kappa values were 0.480(P=0.001),0.565(P<0.001)respectively.The accuracy of diagnosis of thyroid nodules by US-FNA and US-CNB in patients in group B was 73.21%and 78.57%,the sensitivity was 76.92%and 79.49%,the specificity was 64.71%and 76.47%,the positive predictive value was 83.33%and 88.57%,and the negative predictive value was 55.00%and 61.90%,respectively,and the kappa Consistency test was analyzed and the kappa values were 0.525(P<0.001),0.397(p=0.003),respectively.Conclusion:When the patient's thyroid nodule is less then10 mm,US-FNA is chosen for diagnosis with high accuracy;when it is more 10 mm,US-CNB should be chosen for diagnosis.
作者
辛敏慧
张植兰
李忠举
XIN Minhui;ZHANG Zhilan;LI Zhongju(Haikou Hospital,Xiangya School of Medicine,Central South University,Hainan Haikou 570208,China)
出处
《河北医学》
CAS
2023年第8期1298-1302,共5页
Hebei Medicine
基金
海南省自然科学基金面上项目,(编号:819MS140)。
