Kim Dong Wook, Park Auh Whan, Lee Eun Joo, Choo Hye Jung, Kim Sang Hyo, Lee Sang Hyub, Eom Jae Wook
Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Korean J Radiol. 2009 Sep-Oct;10(5):435-40. doi: 10.3348/kjr.2009.10.5.435. Epub 2009 Aug 25.
The aim of this study was to determine the efficacy of the use of an ultrasound-guided fine-needle aspiration biopsy (US-FNAB) to diagnose thyroid nodules smaller than 5 mm in the maximum diameter and to evaluate pathological findings of small thyroid malignancies.
From May 2007 to April 2008, we evaluated the findings of US-FNABs of small thyroid nodules less than 5 mm in the maximum diameter. The cytopathological findings were retrospectively reviewed and the diagnostic performance of the use of an US-FNAB was examined in all patients.
Of 201 small thyroid nodules in 180 patients, there were 162 adequate specimens (81%). Among 180 patients, 75 patients underwent thyroid surgery and 50 malignant and 33 benign nodules were identified based on a pathological examination. All small malignant thyroid nodules were identified as papillary thyroid microcarcinomas (PTMCs). There were 34 (55%) true positive, 0 (0%) false positive, 23 (37%) true negative and five (8%) false negative results for malignancy after performing a first US-FNAB in 62 surgically confirmed nodules. The sensitivity (87%), specificity (100%), positive predictive value (100%), negative predictive value (82%), accuracy (92%), false positive rate (0%) and false negative rate (8%) for an US-FNAB were determined. In 23 patients with a primary PTMC, capsular invasion (9%, 2 of 23), a perithyroidal lymph node metastasis (30%, 7 of 23), the rate of multifocality (9%, 2 of 23) and bilaterality (4%, 1 of 23) were also determined.
An US-FNAB of thyroid nodules smaller than 5 mm in the maximum diameter is an effective diagnostic procedure.
本研究旨在确定超声引导下细针穿刺活检（US-FNAB）用于诊断最大直径小于5mm的甲状腺结节的有效性，并评估小型甲状腺恶性肿瘤的病理结果。
2007年5月至2008年4月，我们评估了最大直径小于5mm的小型甲状腺结节的US-FNAB结果。对细胞病理学结果进行回顾性分析，并检查所有患者使用US-FNAB的诊断性能。
180例患者的201个小型甲状腺结节中，有162个标本足够（81%）。180例患者中，75例接受了甲状腺手术，病理检查发现50个恶性结节和33个良性结节。所有小型甲状腺恶性结节均被诊断为甲状腺微小乳头状癌（PTMC）。对62个经手术证实的结节进行首次US-FNAB后，恶性结果的真阳性为34个（55%）、假阳性为0个（0%）、真阴性为23个（37%）、假阴性为5个（8%）。确定了US-FNAB的敏感性（87%）、特异性（100%）、阳性预测值（100%）、阴性预测值（82%）、准确性（92%）、假阳性率（0%）和假阴性率（8%）。在23例原发性PTMC患者中，还确定了包膜侵犯率（9%，23例中的2例）、甲状腺周围淋巴结转移率（30%，23例中的7例）、多灶性发生率（9%，23例中的2例）和双侧性发生率（4%，23例中的1例）。
最大直径小于5mm的甲状腺结节的US-FNAB是一种有效的诊断方法。
