22号和25号针用于甲状腺结节及淋巴结细针穿刺的比较：一项回顾性研究
Comparison of fine needle aspiration of thyroid nodules and lymph nodes with 22- and 25-gauge needles: a retrospective study.
作者信息
Alzahrani Mohammad Yahia, Abdelghaffar Mohammad Sayed, Adlan Tariq Hashim
机构信息
Department of Interventional Radiology, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
出版信息
Ann Med Surg (Lond). 2025 Jul 30;87(9):5388-5393. doi: 10.1097/MS9.0000000000003664. eCollection 2025 Sep.
BACKGROUND
Approximately 15% of fine-needle aspiration biopsy (FNAB) procedures are considered inconclusive, caused by various factors such as nodule characteristics, level of expertise, and needle size. Since needle size may play a crucial role in both adequacy of FNAB samples and reduction of complications, our objective was to compare cytology specimen adequacy, blood contamination, and findings in thyroid nodules and lymph nodes using 22- and 25-gauge needles in fine-needle aspiration (FNA).
MATERIALS AND METHODS
A retrospective comparative cohort study was conducted at King Fahad Specialist Hospital, Saudi Arabia. Data were collected from electronic medical records between January and December 2021. An ultrasound-guided FNA procedure was performed. Each nodule was sampled in three passes using a 25-gauge and a 22-gauge fine needle. A total of 153 (115 with thyroid nodules; 57 with 22-gauge and 58 with 25-gauge and 38 with lymph nodes; 21 with 22-gauge and 17 with 25-gauge) cases were included. Data analysis was done using SPSS version 26. All cases were divided into two groups: 22-gauge or 25-gauge needle group. Chi-square test and binary logistic regression were used for comparison.
RESULTS
No significant differences were found. Adequacy rates were 93.9% for thyroid and 97.4% for lymph node samples ( = 0.68). Conclusive diagnoses were 97.4% for thyroid and 94.7% for lymph nodes ( = 0.137). Bloody samples were more frequent in lymph nodes (23.7%) than thyroid (11.3%) ( = 0.111). Needle size did not affect adequacy, but the number of passes was a significant predictor (odds ratio: 0.068, 95% confidence interval: 0.008-0.570, = 0.013).
CONCLUSION
The study highlights the importance of the number of passes during the procedure, with a higher number of passes associated with decreased odds of obtaining an adequate sample. The needle size does not significantly impact the various variables assessed.
背景
由于结节特征、专业水平和针的尺寸等多种因素，约15%的细针穿刺活检（FNAB）操作结果被认为不明确。鉴于针的尺寸可能在FNAB样本的充足性和并发症减少方面发挥关键作用，我们的目的是比较在细针穿刺（FNA）中使用22号和25号针获取的甲状腺结节和淋巴结的细胞学标本充足率、血液污染情况及检查结果。
材料与方法
在沙特阿拉伯法赫德国王专科医院进行了一项回顾性比较队列研究。收集了2021年1月至12月期间电子病历中的数据。进行了超声引导下的FNA操作。每个结节使用25号和22号细针各穿刺取材三次。共纳入153例病例（115例甲状腺结节；57例使用22号针，58例使用25号针；38例淋巴结；21例使用22号针，17例使用25号针）。使用SPSS 26版进行数据分析。所有病例分为两组：22号针组或25号针组。采用卡方检验和二元逻辑回归进行比较。
结果
未发现显著差异。甲状腺样本的充足率为93.9%，淋巴结样本的充足率为97.4%（P = 0.68）。甲状腺的确诊率为97.4%，淋巴结的确诊率为94.7%（P = 0.137）。淋巴结中血性样本（23.7%）比甲状腺（11.3%）更常见（P = 0.111）。针的尺寸不影响样本充足率，但穿刺取材次数是一个显著的预测因素（比值比：0.068，95%置信区间：0.008 - 0.570，P = 0.013）。
结论
该研究强调了操作过程中穿刺取材次数的重要性，穿刺取材次数越多，获得充足样本的几率越低。针的尺寸对所评估的各种变量没有显著影响。
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