细针穿刺在评估甲状腺大结节中的价值。
Value of fine-needle aspiration in evaluating large thyroid nodules.
作者信息
Raguin Thibaut, Schneegans Olivier, Rodier Jean-François, Volkmar Pierre-Philippe, Sauleau Eric, Debry Christian, Debonnecaze Guillaume, Ghnassia Jean-Pierre, Dupret-Bories Agnès
机构信息
Service ORL et Chirurgie Cervico-faciale, CHU de Strasbourg, Strasbourg Cedex, France.
Service de Médecine Nucléaire, Centre Paul Strauss, Strasbourg, France.
出版信息
Head Neck. 2017 Jan;39(1):32-36. doi: 10.1002/hed.24524. Epub 2016 Jun 14.
BACKGROUND
The American Thyroid Association (ATA) recommends using ultrasound-guided fine-needle aspiration (FNA) in order to evaluate supracentimetric and suspect thyroid nodules. The purpose of this study was to evaluate the effective use of FNA before surgery for nodules over 3 cm in diameter.
METHODS
In this retrospective study, we analyzed the results of ultrasound-guided FNA and postoperative histological analysis in 843 nodules >3 cm.
RESULTS
The FNA was informative in 42.6%. The correlation with the final histological analysis was 94.8% for benign nodules and 71.0% for malignant nodules. The FNA had a positive predictive value of 71%, a specificity of 97%, a sensitivity of 56%, and a 4.7% rate of false-negative results.
CONCLUSION
Because there is a nonnegligible FNA risk of error, notably allowing the evolution of a cancer in 1 of 20 cases, the FNA data should not delay surgical intervention for potentially suspect nodules >3 cm in diameter. © 2016 Wiley Periodicals, Inc. Head Neck 39: 32-36, 2017.
背景
美国甲状腺协会（ATA）建议使用超声引导下细针穿刺活检（FNA）来评估直径超过1厘米的可疑甲状腺结节。本研究的目的是评估术前对直径超过3厘米的结节进行FNA的有效应用。
方法
在这项回顾性研究中，我们分析了843个直径大于3厘米的结节的超声引导下FNA结果和术后组织学分析结果。
结果
FNA的诊断信息率为42.6%。良性结节与最终组织学分析的相关性为94.8%，恶性结节为71.0%。FNA的阳性预测值为71%，特异性为97%，敏感性为56%，假阴性率为4.7%。
结论
由于FNA存在不可忽视的误诊风险，尤其是在20例中有1例会使癌症病情发展，因此FNA数据不应延误对直径大于3厘米的潜在可疑结节的手术干预。© 2016威利期刊公司。《头颈》39: 32 - 36, 2017。
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