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, Republic of Korea.
Department of Radiology, Namwon Medical Center, 365, Chungjeong-Ro, Namwon-Si, Jeollabuk-Do, 590-702, Republic of Korea.
Sci Rep. 2017 Aug 15;7(1):8242. doi: 10.1038/s41598-017-07924-z.
We compared the efficacy and complications of core-needle biopsy (CNB) with those of fine-needle aspiration (FNA) in a large population of patients with initially detected thyroid nodules via a propensity score analysis. Outpatients with initially detected thyroid nodules, who had undergone CNB or FNA between January 2013 and December 2013, were selected. This study included 4,822 thyroid nodules from 4,553 consecutive patients. Adjustments for significant differences in patients' baseline characteristics were facilitated via propensity score analysis. Subgroup analyses were performed according to nodule sizes ≥ 1 cm. The non-diagnostic result rate, malignancy rate, complication rate, and diagnostic accuracy were compared. A 1:1 matching of 1,615 patients yielded no significant differences between two groups for any covariate. The non-diagnostic result rate was significantly lower in the core-needle biopsy group than in the fine-needle aspiration group (5.2% vs. 12.1%), while the malignancy rate (23.7% vs. 11.8%) and sensitivity (75.9% vs. 55.6%) were significantly higher. However, the specificities were similar (100% and 99.9%, respectively). Propensity score and subgroup analyses showed similar results. The complication rate was similar between groups in matched cohorts. CNB is a promising and safe diagnostic tool for patients with initially detected thyroid nodules.
我们通过倾向评分分析比较了核心针活检（CNB）与细针抽吸（FNA）在大量初诊甲状腺结节患者中的疗效和并发症。选择了 2013 年 1 月至 2013 年 12 月间接受 CNB 或 FNA 的初诊甲状腺结节门诊患者。本研究共纳入 4553 例连续患者的 4822 个甲状腺结节。通过倾向评分分析对患者基线特征的显著差异进行调整。根据结节大小≥1cm 进行亚组分析。比较了非诊断结果率、恶性肿瘤率、并发症率和诊断准确性。1:1 匹配的 1615 例患者在任何协变量上两组间均无显著差异。CNB 组的非诊断结果率显著低于 FNA 组（5.2% vs. 12.1%），而恶性肿瘤率（23.7% vs. 11.8%）和敏感性（75.9% vs. 55.6%）显著升高。然而，特异性相似（分别为 100%和 99.9%）。倾向评分和亚组分析得出了相似的结果。在匹配队列中，两组的并发症发生率相似。CNB 是初诊甲状腺结节患者有前途且安全的诊断工具。
