不同甲状腺结节大小超声引导下细针穿刺细胞学诊断敏感性和准确性比较

doi:10.3969/j.issn.1006-6233.2022.01.017

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Abstract Objective: To compare the sensitivity and accuracy of ultrasound-guided fine-needle aspiration cytology with different sizes of thyroid nodules. Methods: A retrospective analysis method was used to collect the clinical data of patients with thyroid nodules found in the outpatient department of our hospital from April 2018 to April 2021. All patients underwent high-resolution ultrasound, US-FNAC and histopathological examination. According to the maximum diameter of the nodules, 136 nodules finally included in the study were divided into four groups. Group A: the maximum diameter was 4~5mm.Group B: 6~10mm.Group C: 11~20mm. Group D:>20mm. The Bethesda classification of patients with different diameters of thyroid nodules and its relationship with pathological diagnosis results were compared and the diagnostic efficacy of US-FNAC for different diameter thyroid nodules was analyzed. Results: In the Bethesda classification results of US-FNAC cytopathology, there were 1 in category I, 59 in category II, 2 in category III, 2 in category IV, 38 in category V, and 37 in category VI. The malignant rates were 0.00 %, 30.56%, 0.00 %, 100.00 %, 97.37 %, and 100.00 %, respectively, according to the pathological results after operation. The undiagnosed rate of US-FNAC in group A was the highest (4.76 %), but there was no significant difference in the undiagnosed rate between groups (P>0.05). The frequency difference of positive and negative US-FNAC results in ABCD groups was statistically significant (P20 mm nodules had the highest diagnostic sensitivity and accuracy, 100.0 % and 98.3 %, respectively). The diagnostic sensitivity and accuracy of 4~5 mm nodules were low, 92.9% and 90.1 %, respectively. Conclusion: US-FNAC has high value in diagnosing thyroid nodules of different sizes. It has high diagnostic accuracy for thyroid nodules of 11~20mm and >20mm. Patients with thyroid nodules of 4~5mm should be actively followed up. It can be combined with hematological examination or molecular marker detection in clinical diagnosis to avoid missed diagnosis.

Key words： Thyroid nodules Ultrasound guided fine needle aspiration cytology Sensitivity Accuracy

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2022.01.017 OR http://www.hbyxzzs.cn/EN/Y2022/V28/I1/81

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