Zhong Li-Chang, Lu Feng, Ma Fang, Xu Hui-Xiong, Li Dan-Dan, Guo Le-Hang, Sun Li-Ping
Department of Medcial Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China ; Department of Medcial Ultrasound, Shanghai Sixth People's Hospital, Shanghai Jiaotong University School of Medicine Shanghai 200233, China.
Department of Medcial Ultrasound, Shanghai Tenth People's Hospital, Tongji University School of Medicine Shanghai 200072, China ; Institute of Thyroid Diseases, Tongji University School of Medicine Shanghai 200072, China.
Int J Clin Exp Pathol. 2015 Mar 1;8(3):3155-9. eCollection 2015.
The management criterion of thyroid nodules is to evaluate the risk of malignancy, based on cytological examinations. Ultrasound-guided fine-needle aspiration biopsy (US-FNAB) has a highly diagnostic value for thyroid nodules. The aim of this study was to compare the efficacy of US-FNAB for thyroid nodules with different sizes.
From August 2013 to November 2013, 344patients with thyroid nodules who had undergone US-FNAB were divided into three groups, according to the largest diameter of their nodules (group A, ≤5.0 mm; group B, 5.1-10.0 mm; group C, >10.0 mm). All the nodules were subsequently verified by histology or follow-up findings. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value of aspiration cytology in each group was compared.
Among 344 thyroid nodules diagnosed by cytology, the cytology was classified as nondiagnostic or unsatisfactory for 53 (15.4%) lesions, benign for 144 (41.9%) lesions, atypia of undetermined significance or follicular lesion of undetermined significance for 20 (5.8%) lesions, follicular neoplasm or suspicious for a follicular neoplasm for 26 (7.6%) lesions, suspicious for malignancy for 36 (10.5%) lesions, malignant for 65 (18.9%) lesions. There were 243 benign and 101 malignant nodules confirmed by the pathological or follow-up ultrasound. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were confirmed to be 87.5% (14/16), 92.5% (37/40), 91% (51/56), 82.3% (14/17), and 94.8% (37/39) in group A; 92.3% (36/39), 96.9% (94/97), 95.5% (130/136), 92.3% (36/39), and 96.9% (94/97) in group B; and 91.3% (42/46), 93.4% (99/106), 92.7% (141/152) 85.7% (42/49), and 96.1% (99/103), in group C. There were no statistical differences in accuracy, sensitivity, specificity, false positive accuracy, false negative rate of fine needle aspiration of thyroid nodules with different sizes (P>0.05).
US-FNAB has similar diagnostic efficacy to thyroid nodules with different sizes.
甲状腺结节的管理标准是基于细胞学检查评估恶性风险。超声引导下细针穿刺活检（US-FNAB）对甲状腺结节具有高度诊断价值。本研究的目的是比较US-FNAB对不同大小甲状腺结节的疗效。
2013年8月至2013年11月，344例行US-FNAB的甲状腺结节患者，根据结节最大直径分为三组（A组，≤5.0mm；B组，5.1-10.0mm；C组，>10.0mm）。所有结节随后经组织学或随访结果证实。比较每组穿刺细胞学的准确性、敏感性、特异性、阳性预测值、阴性预测值。
在344例经细胞学诊断的甲状腺结节中，53例（15.4%）病变的细胞学分类为非诊断性或不满意，144例（41.9%）病变为良性，20例（5.8%）病变为意义不明确的非典型性或意义不明确的滤泡性病变，26例（7.6%）病变为滤泡性肿瘤或可疑滤泡性肿瘤，36例（10.5%）病变可疑恶性，65例（18.9%）病变为恶性。病理或随访超声证实有243个良性结节和101个恶性结节。A组的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为87.5%（14/16）、92.5%（37/40）、91%（51/56）、82.3%（14/17）和94.8%（37/39）；B组分别为92.3%（36/39）、96.9%（94/97）、95.5%（130/136）、92.3%（36/39）和96.9%（94/97）；C组分别为91.3%（42/46）、93.4%（99/106）、92.7%（141/152）、85.7%（42/49）和96.1%（99/103）。不同大小甲状腺结节细针穿刺的准确性、敏感性、特异性、假阳性准确率、假阴性率差异无统计学意义（P>0.05）。
US-FNAB对不同大小的甲状腺结节具有相似的诊断疗效。
