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直径大于4厘米的甲状腺结节的恶性风险及超声引导下细针穿刺抽吸活检结果的诊断可靠性。

Malignancy risk for thyroid nodules larger than 4 cm and diagnostic reliability of ultrasound-guided FNAB results.

作者信息

Karadeniz Erdem, Yur Mesut, Temiz Ayetullah, Akçay Müfide Nuran

机构信息

Atatürk Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Erzurum, Türkiye.

Trabzon Kanuni Eğitim ve Araştırma Hastanesi, Genel Cerrahi Kliniği, Trabzon, Türkiye.

出版信息

Turk J Surg. 2019 Mar 1;35(1):13-18. doi: 10.5578/turkjsurg.4029. eCollection 2019 Mar.

Abstract

OBJECTIVES

Our aim in the present study was to investigate the relation between thyroid nodule diameter and malignancy, and the diagnostic accuracy of fine needle aspiration biopsy (FNAB) for thyroid nodules larger than 4 cm.

MATERIAL AND METHODS

Preoperative patient demographics such as age and gender, thyroid nodule diameter, FNAB results and postoperative pathology results were recorded. The relation between age, gender, thyroid nodule size of the patients and malignancy was examined. Also, the sensitivity, specificity, false negativity, false positivity and accuracy rates of FNBA of the patients whose thyroid nodule size was lower than 4 cm and the ones whose thyroid nodule size was higher than 4 cm were analyzed.

RESULTS

There was no significant difference between males and females in terms of malignancy rate (p= 0.15). There was no significant relation between malignancy and patient age (p= 0.92). No significant difference was found between the group with thyroid nodule diameter of > 4 cm and the group thyroid with nodule diameter of <4 cm in terms of malignancy (p= 0.91). In the group with thyroid nodule diameter of > 4 cm, sensitivity, specificity, false negativity, false positivity, and accuracy rates of FNAB were 15%, 100%, 84%, 0%, and 70%, respectively. In the group with thyroid nodule diameter of <4 cm, sensitivity, specificity, false negativity, false positivity, and accuracy rates of FNAB were 53%, 100%, 46%, 0% and 80%, respectively.

CONCLUSION

Our study put forward that thyroid nodule diameter is not the only predictor parameter whilst predicting malignancy. However, it was observed that FNAB sensitivity and false negativity were higher when the thyroid nodules with > 4 cm diameter were compared to the thyroid nodules with <4 cm diameter.

摘要

目的

本研究的目的是探讨甲状腺结节直径与恶性肿瘤之间的关系,以及细针穿刺活检(FNAB)对直径大于4 cm的甲状腺结节的诊断准确性。

材料与方法

记录患者术前的人口统计学特征,如年龄和性别、甲状腺结节直径、FNAB结果和术后病理结果。研究患者的年龄、性别、甲状腺结节大小与恶性肿瘤之间的关系。此外,还分析了甲状腺结节大小小于4 cm和大于4 cm的患者FNBA的敏感性、特异性、假阴性、假阳性和准确率。

结果

男性和女性的恶性肿瘤发生率无显著差异(p = 0.15)。恶性肿瘤与患者年龄之间无显著关系(p = 0.92)。甲状腺结节直径>4 cm的组与甲状腺结节直径<4 cm的组在恶性肿瘤方面无显著差异(p = 0.91)。在甲状腺结节直径>4 cm的组中,FNAB的敏感性、特异性、假阴性、假阳性和准确率分别为15%、100%、84%、0%和70%。在甲状腺结节直径<4 cm的组中,FNAB的敏感性、特异性、假阴性、假阳性和准确率分别为53%、100%、46%、0%和80%。

结论

我们的研究提出,甲状腺结节直径不是预测恶性肿瘤的唯一预测参数。然而,观察到直径>4 cm的甲状腺结节与直径<4 cm的甲状腺结节相比,FNAB的敏感性和假阴性更高。

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