摘要
目的：研究甲状腺结节术前超声引导下细针穿刺细胞学检查（US-G FNAC）的诊断价值。方法：回顾性研究2009—2012年在我院完成的甲状腺结节US-G FNAC 360个。使用Bethesda系统标准对结节穿刺结果进行分类判读。手术结节197个，对照US-G FNAC结果与术后组织病理结果，ROC曲线下面积（AUC）用于评价US-G FNAC诊断准确性，并对照各类结节的预测恶性风险（引述Bethesda报告系统）与实际统计恶性风险（术后组织病理结果）。结果：①360个甲状腺结节中197个手术，术前US-G FNAC结果：72个良性（BEN）（36.55％），7个意义不明的细胞非典型病变（AUS）（3.55％），65个可疑滤泡性肿瘤（SFN）（32.99％），7个可疑恶性肿瘤（SFM）（3.55％），33个乳头状癌（16.75％），2个髓样癌（1.02%），2个其他未分化（1.02%），9个标本无法诊断或不满意（INS）（4.57％）。术后组织病理结果：124个BEN（62.94%），21个腺瘤（10.65%），2个滤泡癌（1.02%），46个乳头癌（23.35%），2个髓样癌（1.02%），2个其他（1.02%）。US-G FNAC结果与组织病理结果对照显示US-G FNAC的诊断效能AUC=0.903，诊断准确性高，有统计学意义。②各类结节的恶性预测风险（引述Bethesda报告系统）与实际恶性风险（术后组织病理）基本一致。结论：术前US-G FNAC有较高的诊断准确性。按照TBS报告系统判读US-G FNAC结果能对结节恶性风险适当分层。
Abstract
Objective: This study aimed to assess diagnostic value of ultrasound-guided fine-needle aspiration cytology(US-G FNAC) of thyroid nodules before operation. Methods: Data of 360 US-G FNAC of thyroid nodules in our hospital from 2009 to 2012 were retrospectively collected. Classification and interpretation of US-G FNAC using the Bethesda system standard. 197 nodules were operated on, the results of US-G FNAC were compared with final histology, the area under ROC curve(AUC) was used to assess diagnostic accuracy of US-G FNAC of thyroid nodules, and compared all the risks prediction of malignant nodules(quoted in the Bethesda system) and the actual risks of malignancy(final histology results). Results: ① Among 360 nodules, 197 were operated on, US-G FNAC results were reported as: 72 benign(BEN) (36.55%), 7 atypia of unknown significance(AUS)(3.55%), 65 suspicious for follicular neoplasm(SFN)(32.99%), 7 suspicious for malignancy(SFM)(3.55%), 33 papillary carcinoma(16.75%), 2 medullary carcinoma(1.02%), 2 other(1.02%) and 9 insufficient(INS)(4.57%). Histology results were reported as: 124 BEN(62.94%), 21 Follicular adenoma(10.65%), 2 follicular carcinoma(1.02%), 46 papillary carcinoma(23.35%), 2 medullary carcinoma(1.02%), 2 other(1.02%). US-G FNAC results were compared with final histology, AUC of US-G FNAC=0.903, diagnostic accuracy was high, with statistically significant difference. ②Risk prediction of malignant nodules(quoted the Bethesda system) was same as the actual risk of malignancy(final histology results). Conclusions: Before operation, diagnostic accuracy of US-G FNAC was high. The Bethesda system appropriately stratified lesions for risk of malignancy.
关键词
甲状腺结节 /
活组织检查 /
细针 /
超声检查 /
多普勒 /
彩色
Key words
Thyroid nodule /
Biopsy /
fine-needle /
Ultrasonography /
Doppler /
color
吴 亮;杨顺实;江学庆;袁静萍;李 海;吴志勇;田青青.
超声引导下甲状腺结节细针穿刺细胞学检查的术前诊断价值[J]. 中国临床医学影像杂志. 2014, 25(1): 17-20
WU Liang;YANG Shun-shi;JIANG Xue-qing;YUAN Jing-ping;LI Hai;WU Zhi-yong;TIAN Qing-qing.
Diagnostic value of ultrasound-guided fine-needle aspiration cytology of thyroid nodules before operation[J]. Journal of China Clinic Medical Imaging. 2014, 25(1): 17-20
中图分类号：
Ｒ736.1
R581
Ｒ445.1
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
