甲状腺结节超声特点与甲状腺细胞病理学Bethesda报告系统相关性研究

目的:评估甲状腺结节超声特点与细针穿刺活检（FNAB）细胞病理学Bethesda系统相关性。方法:分析2018年3月1日-2019年10月1日在河北大学附属医院基本外科行超声引导下甲状腺结节FNAB的240例患者，共301例结节。将其超声影像特点与穿刺细胞学结果进行对照分析。采用χ2检验分析不同超声征象特点与FNAB细胞病理学Bethesda系统相关性。结果:根据Bethesda系统评估结果，具有形态不规则（P＜0.01）、点状钙化（P＜0.01）、低回声（P=0.036）、边界不清（P＜0.01）4项超声特点结节与恶性相关性较高，而周边血流信号与结节良恶性无明显关联（P=0.33）。同时发现甲状腺峡部结节恶性风险较高（62.5%）。结论:根据甲状腺细胞Bethesda分类系统评估结果，超声提示形态不规则、具有点状钙化、边界不清、低回声的甲状腺结节恶性可能性更大，在穿刺过程中应优先选择具有前述特点结节。

Study on the correlation between ultrasound characteristics and the Bethesda system for reporting thyroid cytopathology in thyroid nodules

Objective: To evaluate the correlation between ultrasound features of thyroid nodules and the Bethesda system for reporting thyroid cytopathology of fine needle aspiration biopsy（FNAB）. Methods: A total of 240 patients with 301 thyroid nodules under ultrasound-guided fine needle aspiration biopsy（US-FNAB） from March 1, 2018 to October 1, 2019 at the Basic Surgery of Hebei University Affiliated Hospital were analyzed retrospectively. Chi square test was used to analyze the correlation between different ultrasonic features and the Bethesda System for FNAB cytopathology. Results: According to the Bethesda system evaluation, thyroid nodules with four ultrasound features including irregular shape（P＜0.01）, microcalcifications（P＜0.01）, hypoecho （P=0.036） and unclear margin （P＜0.01） were highly correlated with nodal malignancy, while peripheral blood flow signals was not significantly correlated with nodal malignancy（P=0.33）. Conclusion: According to the results of Bethesda classification system of thyroid cells, the thyroid nodules with irregular shape, punctate calcification, unclear margin and hypoecho are more likely to be malignant, and should be selected preferentially in the process of fine needle aspiration.