Hatada T, Okada K, Ishii H, Ichii S, Utsunomiya J
Second Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
Am J Surg. 1998 Feb;175(2):133-6. doi: 10.1016/S0002-9610(97)00274-2.
We retrospectively studied whether ultrasound-guided fine-needle aspiration biopsy (US-FNAB) showed improved sensitivity in patients with palpable thyroid nodules.
A total of 70 patients (72 lesions) with thyroid nodules underwent US-FNAB and 94 patients (94 lesions) underwent FNAB guided by manual palpation (standard FNAB). The diagnoses obtained by US-FNAB were compared with the surgical findings.
The sensitivity of US-FNAB for palpable thyroid nodules was 62% the specificity was 74% the accuracy was 68% the positive predictive value was 100%, the negative predictive value was 70% and the inadequate biopsy rate was 17%. In contrast, the sensitivity of standard FNAB was 45%, the specificity was 51%, the accuracy was 48% the positive predictive value was 96, the negative predictive value was 55, and the inadequate biopsy rate was 30%. The accuracy of US-FNAB was significantly higher than that of standard FNAB. For tumors < or = 2 cm in diameter, the sensitivity and accuracy of US-FNAB were both significantly higher than those of standard FNAB.
These findings suggest that US-FNAB can improve the preoperative diagnosis of thyroid cancer, especially in patients with tumors < or = 2 cm in diameter.
我们回顾性研究了超声引导下细针穿刺活检（US-FNAB）对可触及甲状腺结节患者的敏感性是否有所提高。
共有70例甲状腺结节患者（72个病灶）接受了US-FNAB，94例患者（94个病灶）接受了手工触诊引导下的细针穿刺活检（标准FNAB）。将US-FNAB获得的诊断结果与手术结果进行比较。
US-FNAB对可触及甲状腺结节的敏感性为62%，特异性为74%，准确率为68%，阳性预测值为100%，阴性预测值为70%，活检不充分率为17%。相比之下，标准FNAB的敏感性为45%，特异性为51%，准确率为48%，阳性预测值为96，阴性预测值为55，活检不充分率为30%。US-FNAB的准确率显著高于标准FNAB。对于直径≤2 cm的肿瘤，US-FNAB的敏感性和准确率均显著高于标准FNAB。
这些结果表明，US-FNAB可以改善甲状腺癌的术前诊断，尤其是对于直径≤2 cm的肿瘤患者。
