摘要
目的评价超声引导下细针抽吸细胞学(US-FNA)和粗针穿刺组织学(US-CNB)单独及联合诊断直径>10 mm甲状腺结节良恶性的准确性及安全性。方法 36例直径>10 mm的甲状腺结节,均行US-FNA及US-CNB诊断,回顾性分析两种诊断方法与术后病理诊断结果的符合率以及并发症发生率。结果 US-FNA、US-CNB与术后病理学诊断的符合率分别为75%和94.44%,差异有统计学意义(P<0.05)。两种方法联合诊断与术后病理学诊断符合率为97.22%,与US-CNB单独诊断比较,差异无统计学意义(P>0.05)。US-FNA的灵敏度、阴性预测值分别为66.67%、50%,US-CNB的灵敏度、阴性预测值分别为92.59%、81.82%,两种方法联合诊断的灵敏度、阴性预测值分别为96.30%、90%。两种穿刺方法诊断的特异度、阳性预测值均为100%。仅US-FNA和US-CNB诊断的灵敏度有统计学差异(P<0.05)。两种穿刺方法均未出现并发症。结论 US-CNB是直径>10 mm的甲状腺结节术前诊断的较优选择,结节直径越大,越应选择US-CNB作为穿刺活检方法。
Objective To evaluate the accuracy and safety of ultrasound-guided fine-needle aspiration（US-FNA）and core-needle biopsy（US-CNB） for the separate and joint diagnosis of thyroid nodules bigger than 10 mm in maximum diameter. Methods 36 cases of thyroid nodules bigger than 10 mm in maximum diameter were examined by both US-FNA and US-CNB. Retrospective analysis was conducted on two diagnostic methods in terms of the diagnostic coicidence rate with pathologic diagnosis and complication rate. Results For the 36 cases of thyroid nodules, US-FNA and US-CNB showed diagnostic coincidence rate of 75% and 94.44% respectively, and difference was statistically significant（P〈0.05）. The joint diagnosis by both US-FNA and US-CNB showed diagnostic coincidence rate of 97.22%, but difference was not statistically significant when compared with diagnosis by US-CNB alone. Sensitivity and negative predictive value of US-FNA were 66.67% and 50% respectively in comparison with US-CNB＇s 92.59% and 81.82% and the joint diagnosis method＇s 96.30% and 90%.The specificity and positive predictive value of these two diagnosis methods were both 100%. Only the sensitivity between US-FNA and US-CNB showed statistically significant different（P〈0.05）. No complications occurred in the two puncture methods. Conclusion US-CNB was better puncture method for preoperative diagnosis of thyroid nodules bigger than 10 mm in maximum diameter, and it should be chosen as the preferred method for biopsy when the nodules were larger.
出处
《中国医疗设备》
2016年第5期93-95,112,共4页
China Medical Devices
