Kavanagh John, McVeigh Niall, McCarthy Eoghan, Bennett Kathleen, Beddy Peter
1 Department of Radiology, St. James's Hospital, Dublin, Ireland.
2 Department of Pharmacology & Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Ireland.
Acta Radiol. 2017 Mar;58(3):301-306. doi: 10.1177/0284185116654331. Epub 2016 Jul 20.
Background The incidence of thyroid cancer is increasing in men and women. Fine needle aspiration (FNA) is an accepted technique to assess thyroid nodules but is associated with a high rate of non-diagnostic sampling. Purpose To assess the diagnostic performance of ultrasound-guided FNA of thyroid nodules and identify factors associated with non-diagnostic sampling. Material and Methods A retrospective review of thyroid FNAs was performed between 2006 and 2013. Patient demographics, nodule characteristics, procedural technique, cytology, and complications were recorded. Cytology was categorized THY1-5 based on the British Thyroid Association guidelines. Descriptive and multivariable analysis were conducted to identify factors associated with non-diagnostic sampling. Results A total of 724 procedures were identified with 597 (82.5%) in women, and an overall mean age of 40 years (age range, 17-87 years). Factors associated with a non-diagnostic outcome in the multivariable regression analysis included increasing lesion depth (OR, 1.05 per mm; 95% confidence interval [CI], 1.007-1.10), age (OR, 1.012 per year; 95% CI, 1.0-1.025) and number of FNA passes (1 vs. 4+; OR, 6.07; 95% CI, 2.27-16.21). The complication rate was 1.1% related to perilesional hematomas and vaso-vagal episodes. Conclusion Thyroid FNA is a safe and reliable procedure for cytological assessment of thyroid nodules. Deeper nodules and older patients are more likely to have non-diagnostic samples.
背景 甲状腺癌在男性和女性中的发病率均呈上升趋势。细针穿刺抽吸活检（FNA）是评估甲状腺结节的一种公认技术，但存在较高的非诊断性采样率。目的 评估超声引导下甲状腺结节FNA的诊断性能，并确定与非诊断性采样相关的因素。材料与方法 对2006年至2013年间的甲状腺FNA进行回顾性研究。记录患者人口统计学资料、结节特征、操作技术、细胞学检查结果及并发症情况。根据英国甲状腺协会指南，将细胞学检查结果分为THY1 - 5类。进行描述性和多变量分析以确定与非诊断性采样相关的因素。结果 共识别出724例操作，其中女性597例（82.5%），总体平均年龄40岁（年龄范围17 - 87岁）。多变量回归分析中与非诊断性结果相关的因素包括病变深度增加（比值比[OR]，每毫米1.05；95%置信区间[CI]，1.007 - 1.10）、年龄（OR，每年1.012；95% CI，1.0 - 1.025）以及FNA穿刺次数（1次与4次及以上；OR，6.07；95% CI，2.27 - 16.21）。并发症发生率为1.1%，与病灶周围血肿和血管迷走神经发作有关。结论 甲状腺FNA是一种用于甲状腺结节细胞学评估的安全可靠方法。结节较深和年龄较大的患者更有可能获得非诊断性样本。
