摘要
目的探讨超声引导下甲状腺粗针穿刺活检在甲状腺良恶性结节鉴别诊断中的价值及准确性。方法389例甲状腺结节患者,均进行术前超声引导下甲状腺粗针穿刺活检、手术治疗及术后病理组织学检查。观察手术病理诊断和术前超声引导下甲状腺粗针穿刺活检对甲状腺良恶性结节的检出情况;以手术病理诊断结果作为金标准,分析超声引导下甲状腺粗针穿刺活检对甲状腺结节良恶性的诊断灵敏度、特异度和准确率,并比较超声引导下甲状腺粗针穿刺活检对不同直径甲状腺结节患者的诊断准确率。结果超声引导下甲状腺粗针穿刺活检对良性甲状腺结节的检出率为77.38%(301/389),对恶性甲状腺结节的检出率为22.62%(88/389);手术病理诊断对良性甲状腺结节的检出率为77.63%(302/389),对恶性甲状腺结节的检出率为22.37%(87/389)。超声引导下甲状腺粗针穿刺活检对甲状腺结节良恶性的诊断灵敏度为97.70%(85/87),特异度为99.01%(299/302)、准确率为98.71%(384/389)。超声引导下甲状腺粗针穿刺活检对甲状腺结节直径<0.7cm患者的诊断准确率为88.89%(33/36),显著低于甲状腺结节直径0.7~1.5cm患者的100.00%(197/197)、>1.5cm患者的100.00%(156/156),差异具有统计学意义(P<0.05);超声引导下甲状腺粗针穿刺活检对甲状腺结节直径0.7~1.5cm与>1.5cm患者的诊断准确率比较,差异无统计学意义(P>0.05)。结论超声引导下甲状腺粗针穿刺活检可有效鉴别结节性质,灵敏度与特异度较高,可为良恶性结节诊疗提供较为准确的参考资料,应用价值较高。但是,直径较小的甲状腺结节误诊风险较高,超声引导下甲状腺粗针穿刺活检准确性欠佳,有必要联合其他临床诊断手段共同评估,以提升诊断准确率。
Objective To discuss the value and accuracy of ultrasound-guided thyroid coreneedle aspiration biopsy in the differential diagnosis of benign and malignant thyroid nodules.Methods In 389 patients with thyroid nodules,preoperative ultrasound-guided core-needle aspiration biopsy of the thyroid gland,surgical treatment and postoperative pathological histological examination were performed.The detection of benign and malignant thyroid nodules by surgical pathological diagnosis and preoperative ultrasound-guided coreneedle aspiration biopsy for the thyroid gland was observed.The diagnostic sensitivity,specificity and accuracy of ultrasound-guided core-needle aspiration biopsy on benign and malignant thyroid nodules were analyzed using the surgical pathological diagnosis as the gold standard,and the diagnostic accuracy of ultrasound-guided coreneedle aspiration biopsy for patients with thyroid nodules of different diameters was compared.Results The detection rate of ultrasound-guided core-needle aspiration biopsy of the thyroid gland was 77.38%(301/389)for benign thyroid nodules and 22.62%(88/389)for malignant thyroid nodules.The detection rate of surgical pathological diagnosis was 77.63%(302/389)for benign thyroid nodules and 22.37%(87/389)for malignant thyroid nodules.The sensitivity of ultrasound-guided core-needle aspiration biopsy for the diagnosis of benign and malignant thyroid nodules was 97.70%(85/87),the specificity was 99.01%(299/302),and the accuracy was 98.71%(384/389).The diagnostic accuracy of ultrasound-guided core-needle aspiration biopsy of thyroid nodules<0.7cm in diameter was 88.89%(33/36),which was significantly lower than that of 100.00%(197/197)in patients with thyroid nodules 0.7-1.5cm in diameter and 100.00%(156/156)in patients with nodules>1.5cm in diameter,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the diagnostic accuracy of ultrasound-guided core-needle aspiration biopsy of the thyroid gland for patients with thyroid nodules 0.7-1.5 cm in diameter compared with those>1.5 cm(P>0.05).Conclusion Ultrasound-guided thyroid core-needle biopsy can effectively distinguish the nature of nodules,with high sensitivity and specificity,which can provide more accurate reference data for the diagnosis and treatment of benign and malignant nodules,with high application value.However,the risk of misdiagnosis is high for small diameter thyroid nodules,and the accuracy of ultrasound-guided core-needle aspiration biopsy of the thyroid gland is poor.It is necessary to evaluate the thyroid nodules with other clinical diagnostic methods to improve the diagnostic accuracy.
作者
赵颖
杨广辉
张艳
吴敦新
ZHAO Ying;YANG Guang-hui;ZHANG Yan(Department of Ultrasound,Peixian County People's Hospital,Xuzhou 221600,China)
出处
《中国现代药物应用》
2023年第2期50-53,共4页
Chinese Journal of Modern Drug Application
关键词
超声引导
甲状腺
粗针穿刺
活检
良恶性结节
鉴别诊断
Ultrasound guidance
Thyroid
Core-needle aspiration
Biopsy
Benign and malignant nodules
Differential diagnosis
