甲状腺恶性风险结节的颈部超声评估：单中心经验
Cervical ultrasound assessment of thyroid nodules at risk of malignancy: single-center experience.
作者信息
Neagoe O C, Ionica M, Mazilu O
出版信息
G Chir. 2017 Sep-Oct;38(5):233-238. doi: 10.11138/gchir/2017.38.5.233.
AIM
The increasing diagnosis of thyroid nodules makes proper assessment of their nature and course of treatment essential, considering that thyroidectomy may be unnecessary and only contribute to higher healthcare system costs. Although criteria have been proposed for the stratification of these patients according to risk by use of cervical ultrasound and fine needle aspiration biopsy (FNAB), not all medical units may be equipped or have access to trained medical professionals to perform FNAB. The aim of this study was to show that cervical ultrasound may be sufficient for the evaluation of thyroid nodules in the treatment decision-making process.
PATIENTS AND METHODS
206 patients with single thyroid nodules and nodular goiter were assessed through cervical ultrasound and FNAB for the correlation between pretreatment classification and final diagnosis on histological examination.
RESULTS
26.5% of single nodes proved malignant on paraffin studies, as compared to only 14% of nodular goiters. FNAB recorded a sensibility of 33.3%, specificity of 93.3%, false-negative rate of 50% and false-positive rate of 12.5%, whereas cervical ultrasound recorded a sensibility of 92.3%, specificity of 75.3%, false-negative rate of 2.8% and false-positive rate of 48.9%.
CONCLUSION
Cervical ultrasound evaluation is a reliable method in the preoperative diagnosis of thyroid cancer patients.
目的
甲状腺结节的诊断日益增多，鉴于甲状腺切除术可能并非必要且只会增加医疗系统成本，因此对其性质和治疗过程进行恰当评估至关重要。尽管已提出根据颈部超声和细针穿刺活检（FNAB）对这些患者进行风险分层的标准，但并非所有医疗单位都具备进行FNAB的设备或有经过培训的专业医务人员。本研究的目的是表明颈部超声在治疗决策过程中对甲状腺结节的评估可能就足够了。
患者与方法
对206例患有单个甲状腺结节和结节性甲状腺肿的患者进行颈部超声和FNAB评估，以确定术前分类与组织学检查最终诊断之间的相关性。
结果
石蜡切片研究显示，单个结节中有26.5%为恶性，而结节性甲状腺肿中仅为14%。FNAB的敏感性为33.3%，特异性为93.3%，假阴性率为50%，假阳性率为12.5%；而颈部超声的敏感性为92.3%，特异性为75.3%，假阴性率为2.8%，假阳性率为48.9%。
结论
颈部超声评估是甲状腺癌患者术前诊断的可靠方法。
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