超声引导下甲状腺结节细针穿刺细胞学与粗针穿刺组织学检查的对比研究CSCD

目的比较超声引导下甲状腺结节细针穿刺细胞学与粗针穿刺组织学检查的诊断准确率、敏感度、特异性及并发症。方法收集95例超声检查疑似为恶性甲状腺结节患者的98个结节,行超声引导下细针穿刺细胞学与粗针穿刺组织学检查,并经术后常规病理检查证实。比较两种方法诊断甲状腺结节的准确率、敏感度、特异性及术后并发症。分析结节直径大小与取材满意率、诊断准确率的关系。结果 (1)细针穿刺取材满意率89.8%,粗针为96.9%。细针穿刺细胞学诊断甲状腺结节的准确率、敏感度、特异性分别为86.4%、90.5%、82.6%;粗针穿刺组织学诊断为90.5%、91.7%、88.6%;(2)粗针穿刺并发症发生率高于细针穿刺(14.3% vs.2.0%,P<0.05);(3)结节直径≥1.0 cm时,粗针穿刺诊断准确率高于细针穿刺(P<0.05)。结论细针穿刺细胞学与粗针穿刺组织学检查在甲状腺结节良恶性诊断中可互相补充。

A Comparative Study of Ultrasound-guided Fine Needle Aspiration Cytology versus Core-needle Biopsy Histology in Thyroid Nodules

Objective To compare the diagnostic accuracy, sensitivity, specificity and complications between ultrasound-guided fine needle aspiration cytology and core needle biopsy histology in thyroid nodules. Methods A total of 98 thyroid nodules of 95 patients suspected as malignancy by ultrasonography were collected and examined by ultrasonic-guided fine needle aspiration cytology and core needle biopsy histology, which were confirmed by surgical treatment and postoperative routine pathological examination. The diagnostic accuracy, sensitivity, specificity and complications of the two methods were compared. The correlation of nodules diameter with the adequacy and diagnostic accuracy was analyzed. Results The adequacy of fine needle aspiration and core needle biopsy were 89.8% and 96.9%. The accuracy, sensitivity, specificity of fine needle aspiration cytology and core needle biopsy histology in diagnosing thyroid nodules were 86.4%, 82.6%, 90.5% and 90.5%, 93.2%, 86.1%, respectively. The complication rate of core needle biopsy was higher than that of fine needle aspiration (14.3% vs. 2.0%, P<0.05). When the diameter of the thyroid nodules was ≥1.0 cm, the diagnostic accuracy of the core needle biopsy was higher than that of the fine needle aspiration (P<0.05). Conclusion Fine needle aspiration cytology and core needle biopsy histology are complementary in the diagnosis of thyroid nodules.