FNA 穿刺手感在诊断不典型及不确定甲状腺结节中的临床价值。

Clinical value of FNA puncture feeling in the diagnosis of non-diagnostic and indeterminate thyroid nodules.

机构信息

Department of Ultrasound, Linzi District Maternity and Child Health Care Hospital, Zibo, China.

Department of Ultrasound, Chinese PLA General Hospital, Beijing, China.

出版信息

Front Endocrinol (Lausanne). 2022 Nov 2;13:1022438. doi: 10.3389/fendo.2022.1022438. eCollection 2022.

DOI:10.3389/fendo.2022.1022438

PMID:36407324

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9666674/

Abstract

OBJECTIVE

The aim of this study was to explore the clinical diagnostic value of puncture feeling during fine-needle aspiration (FNA) for non-diagnostic and indeterminate thyroid nodules.

METHODS

A retrospective analysis was performed on 176 patients (196 nodules) diagnosed with Bethesda I or III by FNA cytology at the ultrasound department of our hospital between January 2017 and January 2020. Comparisons were made on the differences in puncture feeling (including stiffness and grittiness) between benign and malignant thyroid nodules, and their diagnostic performance was analyzed.

RESULTS

There were significant differences between benign and malignant nodules with respect to the puncture stiffness and puncture grittiness ( < 0.001). The presence of a hard stiffness and grittiness demonstrated comparable levels of diagnostic performance for malignant thyroid nodules, with sensitivities, specificities, accuracies, positive predictive values, and negative predicative values of 55.56% and 63.89%, 87.10% and 78.22%, 75.51% and 72.96%, 71.43% and 63.01%, and 77.14% and 78.86%, respectively. The diagnostic performance was most optimal in the presence of at least one puncture feeling (area under the receiver operating characteristic curve: 0.771), exhibiting a sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 79.17%, 75.00%, 76.53%, 64.77, and 86.11%%, respectively.

CONCLUSIONS

Puncture feeling adds clinical value in the diagnosis of thyroid nodules with indeterminate FNA findings.

摘要

目的

本研究旨在探讨细针穿刺（FNA）过程中针感在非典型和不确定甲状腺结节中的临床诊断价值。

方法

对 2017 年 1 月至 2020 年 1 月我院超声科因 FNA 细胞学检查诊断为 BethesdaⅠ或Ⅲ类的 176 例（196 个结节）患者进行回顾性分析。比较良性和恶性甲状腺结节针感（包括硬度和粗糙感）的差异，并分析其诊断性能。

结果

良性和恶性结节在穿刺硬度和穿刺粗糙感方面存在显著差异（<0.001）。硬而粗糙的针感对恶性甲状腺结节的诊断性能相当，其敏感性、特异性、准确性、阳性预测值和阴性预测值分别为 55.56%和 63.89%、87.10%和 78.22%、75.51%和 72.96%、71.43%和 63.01%和 77.14%和 78.86%。当至少有一种穿刺感觉存在时，诊断性能最佳（受试者工作特征曲线下面积：0.771），其敏感性、特异性、准确性、阳性预测值和阴性预测值分别为 79.17%、75.00%、76.53%、64.77%和 86.11%。