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超声引导下细针穿刺细胞学检查在诊断亚厘米级甲状腺结节中的应用

Fine needle aspiration cytology guided by ultrasound in the diagnosis of subcentimetre thyroid nodules.

作者信息

Li Cheng, Zhan Weiwei, Yi Fang, Zheng Bin, Zhou Yaqin, Zhao Ran, Jia Yi

机构信息

Department of Ultrasound, North Branch of Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Department of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

出版信息

Springerplus. 2016 Jun 24;5(1):876. doi: 10.1186/s40064-016-2555-0. eCollection 2016.

Abstract

BACKGROUND

This study aimed to investigate the value of fine needle aspiration biopsy (FNAB) under ultrasound guidance in diagnosis of thyroid nodules. In a retrospective analysis of FNAB in 1050 cases of patients with 1100 nodules, patients were divided according to the maximum diameter of their nodules into two groups: >1.0 and ≤1.0 cm. The ultrasound-guided FNAB cytology results were compared between two groups.

RESULTS

Ultrasound findings showed that among 1100 thyroid nodules, 547 were highly suspicious, 358 were moderately, 175 were low, and 19 were very low. Cytology results showed papillary carcinomas in 453, possible papillary cancer in 126 cases, follicular tumors in 26, suspicious follicular tumors in 6, atypical cells in 7, nodular goiter in 289, colloid in 13, chronic lymphocytic thyroiditis in 175, and undiagnosed specimen in 5. Ultrasound diagnosis of thyroid nodules had an overall sensitivity of 86.0 %, and a specificity of 81.9 %. In nodules larger than 1.0 cm, the sensitivity was 92.8 %, and the specificity 92.3 %. In nodules ≤1.0 cm, the sensitivity was 82.4 %, and the specificity was 81.7 %.

CONCLUSIONS

Patients with highly suspicious thyroid nodules on ultrasonography, regardless of nodule sizes, should receive ultrasound-guided FNAB to confirm their natures and direct clinical managements.

摘要

背景

本研究旨在探讨超声引导下细针穿刺活检(FNAB)在甲状腺结节诊断中的价值。对1050例患者的1100个结节进行FNAB回顾性分析,根据结节最大直径将患者分为两组:>1.0 cm和≤1.0 cm。比较两组超声引导下FNAB细胞学结果。

结果

超声检查发现,1100个甲状腺结节中,高度可疑547个,中度可疑358个,低度可疑175个,极低度可疑19个。细胞学结果显示,乳头状癌453例,可能的乳头状癌126例,滤泡性肿瘤26例,可疑滤泡性肿瘤6例,非典型细胞7例,结节性甲状腺肿289例,胶质13例,慢性淋巴细胞性甲状腺炎175例,未诊断标本5例。超声诊断甲状腺结节的总体敏感性为86.0%,特异性为81.9%。直径>1.0 cm的结节,敏感性为92.8%,特异性为92.3%。直径≤1.0 cm的结节,敏感性为82.4%,特异性为81.7%。

结论

超声检查高度可疑的甲状腺结节患者,无论结节大小,均应接受超声引导下FNAB以明确其性质并指导临床处理。

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A 2015 Survey of Clinical Practice Patterns in the Management of Thyroid Nodules.2015 年甲状腺结节管理临床实践模式调查。
J Clin Endocrinol Metab. 2016 Jul;101(7):2853-62. doi: 10.1210/jc.2016-1155. Epub 2016 Mar 25.

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