Ha Eun Ju, Baek Jung Hwan, Lee Jeong Hyun, Kim Jae Kyun, Song Dong Eun, Kim Won Bae, Hong Suck Joon
Department of Radiology, Ajou University School of Medicine, Wonchon-Dong, Yeongtong-Gu, Suwon, 443-380, Korea.
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-gu, Seoul, 138-736, Korea.
Eur Radiol. 2016 Apr;26(4):1031-6. doi: 10.1007/s00330-015-3921-y. Epub 2015 Jul 23.
To evaluate the diagnostic performance of fine needle aspiration (FNA) and core needle biopsy (CNB) in patients with anaplastic thyroid cancer (ATC) or thyroid lymphoma (TL).
Between January 2000 and March 2012, 104 patients were diagnosed with ATC or TL by means of ultrasound (US)-guided FNA, CNB, or surgery. This study ultimately included 99 patients with ATC (n = 59) or TL (n = 40). We evaluated the sensitivity and positive predictive value of FNA and CNB for the diagnosis of ATC and TL, and compared the rates of diagnostic surgery between FNA and CNB.
FNA was used in 83 patients, and CNB was used in 32 patients initially (n = 16), after FNA results (n = 8), or simultaneously with FNA (n = 8). CNB achieved sensitivity of 87.5 % (28/32) and positive predictive value of 100.0 % (28/28) for the diagnosis of ATC and TL. The respective values for FNA were 50.6 % (40/79) and 90.9 % (40/44). The rate of diagnostic surgery was significantly lower after CNB (4/32, 12.5 %) than after FNA (28/79, 35.4 %) (p = 0.020).
CNB was able to reduce unnecessary diagnostic surgery in patients with ATC or TL by virtue of its superior diagnostic sensitivity and positive predictive value compared to FNA.
• Diagnostic sensitivity and PPV for CNB were 87.5 % and 100.0 %, respectively. • The respective values for FNA were 50.6 % and 91.0 % for ATC and TL. • Diagnostic surgery rates were reduced after CNB compared to FNA (p = 0.020).
评估细针穿刺抽吸活检（FNA）和粗针穿刺活检（CNB）在间变性甲状腺癌（ATC）或甲状腺淋巴瘤（TL）患者中的诊断效能。
2000年1月至2012年3月期间，104例患者通过超声（US）引导下的FNA、CNB或手术被诊断为ATC或TL。本研究最终纳入99例ATC患者（n = 59）或TL患者（n = 40）。我们评估了FNA和CNB对ATC和TL诊断的敏感性和阳性预测值，并比较了FNA和CNB之间的诊断性手术率。
83例患者采用了FNA，32例患者最初采用了CNB（n = 16），FNA结果出来后采用CNB（n = 8），或与FNA同时采用CNB（n = 8）。CNB对ATC和TL诊断的敏感性为87.5%（28/32），阳性预测值为100.0%（28/28）。FNA的相应值分别为50.6%（40/79）和90.9%（40/44）。CNB后的诊断性手术率（4/32，12.5%）显著低于FNA后（28/79，35.4%）（p = 0.020）。
与FNA相比，CNB凭借其更高的诊断敏感性和阳性预测值，能够减少ATC或TL患者不必要的诊断性手术。
• CNB的诊断敏感性和PPV分别为87.5%和100.0%。• ATC和TL的FNA相应值分别为50.6%和91.0%。• 与FNA相比，CNB后的诊断性手术率降低（p = 0.020）。
