河北医科大学学报 ›› 2022, Vol. 43 ›› Issue (10): 1178-1182.doi: 10.3969/j.issn.1007-3205.2022.10.013

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甲状腺结节大小对细针穿刺细胞学及多模态超声诊断准确度的影响

  

  1. 河北省邯郸市第一医院功能科，河北 邯郸 056002

  • 出版日期:2022-10-25 发布日期:2022-11-16
  • 作者简介:花霞（1974-），女，河北行唐人，河北省邯郸市第一医院主任医师，医学学士，从事甲状腺乳腺疾病的超声诊断研究。
  • 基金资助:
    河北省医学科学研究课题计划（20211043）

The influence of thyroid nodule size on the accuracy of fine needle aspiration cytology and multimodal ultrasound diagnosis

  1. Department of Function, the First Hospital of Handan City, Hebei Province, Handan 056002, China
  • Online:2022-10-25 Published:2022-11-16

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摘要： 目的 探讨细针穿刺细胞学（fine-needle aspiration cytology，FNAC）及多模态超声及两者联合在不同大小甲状腺结节诊断准确度。
方法 回顾性选取甲状腺结节患者152例（160个结节），所有患者均行FNAC、多模态超声及组织病理检查，根据结节大小分组：A组（≤10 mm）64个结节，B组（10～30 mm）61个结节，C组（≥30 mm）35个结节；以组织病理为金标准，分析比较各组FNAC、多模态超声及联合的诊断准确度。
结果 160个甲状腺结节组织病理检出恶性结节75个，FNAC检查检出Ⅰ级结节5个、Ⅱ级结节45个、Ⅲ级结节25个、Ⅳ级结节23个、Ⅴ级结节27个、Ⅵ级结节35个；B组、C组FNAC的准确度、敏感度高于A组，B组特异度高于A组、C组（P＜0.05）；3组多模态超声的准确度、特异度、敏感度比较差异无统计学意义（P＞0.05）；A组联合的准确度、特异度、敏感度高于FNAC（P＜0.05）；C组联合的准确度、特异度高于FNAC（P＜0.05）。
结论 大小≤10 mm、≥30 mm的甲状腺结节会降低FNAC对其良恶性诊断准确度，联合多模态超声诊断有利于提高FNAC诊断≤10 mm、≥30 mm的甲状腺结节良恶性的准确度。


关键词: 甲状腺结节, 活组织检查, 细针, 多模态超声

Abstract: Objective To investigate the accuracy of fine needle aspiration cytology(FNAC), multimodal ultrasound and the combination of the two in the diagnosis of thyroid nodules of different sizes. 
Methods We retrospectively selected 152 patients(160 nodules) with thyroid nodules. All patients underwent FNAC, multimodal ultrasound and histopathological examinations, and divided into different groups according to the size of the nodules: group A(≤10 mm, 64 nodules), group B(10-30 mm, 61 nodules), and group C(≥30 mm, 35 nodules). Histopathology was used as the gold standard, to analyze and compare the diagnostic accuracy of FNAC, multimodal ultrasound and the combination of the two. 
Results There were 75 malignant nodules detected in 160 thyroid nodules by histopathology, and 5 grade I nodules, 45 grade Ⅱ nodules, 25 grade Ⅲ nodules, 23 grade Ⅳ nodules, 27 grade Ⅴnodules and 35 grade VI nodules detected by FNAC examination. The accuracy and sensitivity of FNAC in groups B and C were significantly higher than those of group A, and the specificity in group B was significantly higher than that of groups A and C(P＜0.05). The accuracy, specificity, and sensitivity of the three groups of multimodal ultrasound were not statistically different(P＞0.05). The accuracy, specificity, and sensitivity of combined detection in group A were significantly higher than those of FNAC(P＜0.05); The accuracy and specificity of combined detection in group C were significantly higher than those of FNAC(P＜0.05). 
Conclusion Thyroid nodules ≤10 mm and ≥30 mm in size will reduce the accuracy of FNAC in the diagnosis of benign and malignant thyroid nodules. Combination with multimodal ultrasound diagnosis is beneficial to improve the accuracy of FNAC in the diagnosis of benign and malignant thyroid nodules ≤10 mm and ≥30 mm in size.


Key words: thyroid nodule, biopsy, fine-needle, multimodal ultrasound

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