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普通外科医生与介入放射科医生进行的1869例甲状腺超声引导下细针穿刺活检的比较。

Comparison of 1869 thyroid ultrasound-guided fine-needle aspiration biopsies between general surgeons and interventional radiologists.

作者信息

Bozkurt Hilmi, İrkörücü Oktay, Aziret Mehmet, Reyhan Enver, Okuyan Mehmet Kemal

机构信息

Health Sciences University Adana Numune Training and Research Hospital, Department of General Surgery, Adana, Turkey.

Sakarya University Faculty of Medicine, Department of General Surgery, Sakarya, Turkey.

出版信息

Ann Med Surg (Lond). 2016 Aug 2;10:92-102. doi: 10.1016/j.amsu.2016.07.015. eCollection 2016 Sep.

Abstract

BACKGROUND

Thyroid nodules are commonly encountered problems in clinical practice. For patients who have a thyroid nodule, the fine-needle aspiration biopsy (FNAB) is the most important test, as it is the most reliable diagnostic method for distinguishing between benign thyroid nodules and cancerous nodules. FNAB is able to be performed either via an ultrasound (USG) or alone and is the first choice when it comes to diagnosing thyroid nodules, given that it is cheap, safe and provides accurate results.

OBJECTIVE

In this study-a retrospective analysis of FNAB via USG - our aim is to evaluate the multiple variables related to FNAB procedures, including the experience of the person performing the biopsy, the age and gender of the patient, the number of nodules, the size of the nodule(s) and the number of lams recorded from the cytopathology report on non-diagnostic rates, conducted at an invasive radiology clinic and at a general surgery clinic.

MATERIALS AND METHODS

A total of 1062 patients involving 1869 nodules, examined using FNAB via USG, were reviewed retrospectively from records dated between November 2011 and July 2014 and from pathology reports taken from the ANEAH General Surgery clinic and Interventional Radiology clinic. Cytopathology results were classified according to the 2007 Bethesda System for Reporting. Gender, age, number of nodules, diameter of the nodules, biopsied nodules, location of the nodules, number of lams, symptoms and the date of biopsies were the parameters used to examine the factors involved in non-diagnostic cytopathology invasive radiology. These parameters were inspected at both of the clinics (ANEAH General Surgery clinic and Interventional Radiology clinic). In analyzing the results, the statistical significance level was set at 0.05, where in cases that the p value was under 0.05 (p < 0.05), it was determined that no significant relationship existed. In this study, data were analyzed using SPSS 20 software.

RESULTS

Of the nodules reviewed, 1620 were found on females and 249 on males. The age of the patients ranged from 10 to 87 years, with the mean age being 50 years. In the general surgery clinic, 470 nodules of 341 patients were aspirated, and in the interventional radiological clinic, 1399 nodules of 721 patients were aspirated. In the literature review conducted to compare statistical assessments of FNAB via USG, no significant difference was found between the ANEAH General Surgery clinic and the Invasive Radiology clinic (p > 0.05). In the invasive radiology clinic, non-diagnostic rates decreased with the increase in experience of the person who conducted the biopsy (p = 0.001).

CONCLUSION

The results from both of the clinic's rates of non-diagnostic FNAB, performed via USG, were found to be acceptable. Our study also demonstrates that USG-guided FNAB can be performed with a low non-diagnostic rate as experience grows.

摘要

背景

甲状腺结节是临床实践中常见的问题。对于患有甲状腺结节的患者,细针穿刺活检(FNAB)是最重要的检查,因为它是区分良性甲状腺结节和癌性结节最可靠的诊断方法。FNAB既可以通过超声(USG)进行,也可以单独进行,鉴于其价格便宜、安全且结果准确,它是诊断甲状腺结节的首选方法。

目的

在本研究——一项通过USG对FNAB进行的回顾性分析中,我们的目的是评估与FNAB操作相关的多个变量,包括进行活检的人员的经验、患者的年龄和性别、结节数量、结节大小以及从细胞病理学报告中记录的薄片数量对非诊断率的影响,这些研究在一家介入放射学诊所和一家普通外科诊所进行。

材料与方法

回顾性分析了2011年11月至2014年7月期间记录的1062例患者的1869个结节,这些患者均通过USG进行了FNAB检查,并参考了ANEAH普通外科诊所和介入放射学诊所的病理报告。细胞病理学结果根据2007年贝塞斯达报告系统进行分类。性别、年龄、结节数量、结节直径、活检结节、结节位置、薄片数量、症状和活检日期是用于检查非诊断性细胞病理学介入放射学相关因素的参数。这些参数在两家诊所(ANEAH普通外科诊所和介入放射学诊所)均进行了检查。在分析结果时,统计显著性水平设定为0.05,即p值低于0.05(p < 0.05)时,确定不存在显著关系。在本研究中,使用SPSS 20软件对数据进行分析。

结果

在检查的结节中,发现1620个在女性中,249个在男性中。患者年龄范围为10至87岁,平均年龄为50岁。在普通外科诊所,对341例患者的470个结节进行了抽吸,在介入放射学诊所,对721例患者的1399个结节进行了抽吸。在为比较通过USG进行的FNAB的统计评估而进行的文献综述中,未发现ANEAH普通外科诊所和介入放射学诊所之间存在显著差异(p > 0.05)。在介入放射学诊所,非诊断率随着进行活检的人员经验的增加而降低(p = 0.001)。

结论

两家诊所通过USG进行的FNAB非诊断率结果均可接受。我们的研究还表明,随着经验的增加,USG引导下的FNAB可以以较低的非诊断率进行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a68a/4995479/48e74b08411f/gr1.jpg

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