22G和25G细针对超声引导下甲状腺富血供结节穿刺标本满意率的比较
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摘要
目的:比较22G和25G型号细针对甲状腺结节穿刺标本的满意率。方法:纳入2017年1月至2018年1月至南京市第一医院进行甲状腺结节细针穿刺的166例患者(166个结节),所有结节均用22G和25G针进行超声引导下细针穿刺抽吸细胞学检查(ultrasound-guided fine needle aspiration cytology,US-FNAC)。将甲状腺结节内部血流根据Adler分级法分为乏血供组(Adler0～2级)与富血供组(Adler3级)。所有标本进行细胞病理学涂片及液基薄层细胞学制片技术(thin-preparation cytologic test,TCT)检查,将标本分为满意和不满意2种。22G和25G针穿刺的先后顺序按照随机表进行,比较2种细针在进行甲状腺结节穿刺时标本的满意率。结果:22G针穿刺甲状腺结节的标本满意率83.1%(138/166),25G针穿刺甲状腺结节的标本满意率89.8%(149/166),差异无统计学意义(P=0.07)。乏血供组结节的22G及25G针穿刺标本满意率差异无统计学意义(80.4%vs82.1%,P=0.81),富血供组结节25G标本满意率显著高于22G,差异有统计学意义(84.5%vs 93.6%,P=0.03)。结论:25G针取的细胞结构可以满足甲状腺结节细针穿刺细胞学病理诊断的标准,富血供结节使用25G针时标本满意率更高。
Objective: To compare the sample satisfaction rate of 22 G and 25 G needles used in the ultrasound-guided fine needle aspiration cytology(US-FNAC) of thyroid nodules. Methods: A total of 166 patients, 166 thyroid nodules from January 2017 to January 2018 in our hospital were included in this study, each nodule was aspirated withboth 22 G and 25 G needles guided by ultrasound. According to the Adler stratifications of vascularity, 166 thyroid nodules were divided into a non-hypervascular group(Adler level 0–2) and a hypervascular group(Adler level 3). All specimens were directly smeared on glass slides and subjected to Thinprep Cytologic Test. Samples were divided into satisfied or unsatisfied. The order of 22 G and 25 G needle was in terms of random table, then the satisfaction rate between 22 G and 25 G was compared. Results: The satisfaction rate of 22 G needle aspiration of thyroid nodules was 83.1%(138/166), while the satisfaction rate of 25 G needle aspiration of thyroid nodules was 89.8%(149/166). There was no statistically significant difference between 22 G and 25 G needles in terms of the sample satisfaction rate(P=0.07). There was no statistically significant difference in a non-hypervascular group either(80.4% vs 82.1%, P=0.81). However, the sample satisfaction rate of a hypervascular group showed significant difference(84.5% vs 93.6%, P=0.03). Conclusion: 25 G needles can aspirate adequate material for cytopathological diagnosis, it may have a higher satisfaction rate in nodules with rich blood supply.
Objective: To compare the sample satisfaction rate of 22 G and 25 G needles used in the ultrasound-guided fine needle aspiration cytology(US-FNAC) of thyroid nodules. Methods: A total of 166 patients, 166 thyroid nodules from January 2017 to January 2018 in our hospital were included in this study, each nodule was aspirated withboth 22 G and 25 G needles guided by ultrasound. According to the Adler stratifications of vascularity, 166 thyroid nodules were divided into a non-hypervascular group(Adler level 0–2) and a hypervascular group(Adler level 3). All specimens were directly smeared on glass slides and subjected to Thinprep Cytologic Test. Samples were divided into satisfied or unsatisfied. The order of 22 G and 25 G needle was in terms of random table, then the satisfaction rate between 22 G and 25 G was compared. Results: The satisfaction rate of 22 G needle aspiration of thyroid nodules was 83.1%(138/166), while the satisfaction rate of 25 G needle aspiration of thyroid nodules was 89.8%(149/166). There was no statistically significant difference between 22 G and 25 G needles in terms of the sample satisfaction rate(P=0.07). There was no statistically significant difference in a non-hypervascular group either(80.4% vs 82.1%, P=0.81). However, the sample satisfaction rate of a hypervascular group showed significant difference(84.5% vs 93.6%, P=0.03). Conclusion: 25 G needles can aspirate adequate material for cytopathological diagnosis, it may have a higher satisfaction rate in nodules with rich blood supply.
引文
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2 .张琼,彭玉兰,马步云,等.甲状腺结节大小对超声引导细针抽吸细胞学检查有效率的影响[J].中国普外基础与临床杂志, 2015,22(7):832-835.ZHANG Qiong, PENG Yulan, MA Buyun, et al. Effect on efficiency of tyroid nodules’ size for ultrasound-guided fine-needle aspiration biopsy[J]. Chinese Journal of Bases and Clinics in General Surgery,2015, 22(7):832-835.
3.Haugen BR, Alexander EK, Bible KC, et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodulesanddifferentiatedthyroidcancer:theamericanthyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer[J]. Thyroid, 2016, 26(1):1-133.
4 .Gümü?M, Cay N, Algin O, et al. Comparison of 21 and 27 gauge needles for determining sample adequacy in the aspiration biopsy o thyroid nodules[J]. Diagn Interv Radiol, 2012, 18(1):102-105.
5 .Zhang L, Liu Y, Tan X, et al. Comparison of different-gauge needles fo fine-needle aspiration biopsy of thyroid nodules[J]. J Ultrasound Med2018, 37(7):1713-1716.
6 .梁淑琴.彩色多普勒超声对甲状腺结节的诊断价值研究[J].实用心脑肺血管病杂志, 2013, 21(5):135-136.LIANGShuqin.ThevalueofcolorDopplerultrasoundinthe diagnostic of thyroid nodules[J]. Practical Journal of Cardiac Cerebra Pneumal and Vascular Disease, 2013, 21(5):135-136.
7 .Grani G, Calvanese A, Carbotta G, et al. Intrinsic factors affecting adequacy of thyroid nodule fine-needle aspiration cytology[J]. Clin Endocrinol(Oxf), 2013, 78(1):141-144.
8 .冯伶艳,钱林学,刘玉江,等. 21G和23G细针对超声引导下甲状腺结节穿刺标本满意率的比较[J].中华医学超声杂志(电子版), 2015, 12(10):763-767.FENG Lingyan, QIAN Linxue, LIU Yujiang, et al. Comparison the samplesatisfactionrateof21and23gaugeneedlesusedforthe ultrasound-guided fine needle aspiration biopsy of thyroid nodules[J]Chinese Journal of Medical Ultrasound. Electronic Edition, 201512(10):763-767.
9 .DegirmenciB,HaktanirA,AlbayrakR,etal.Sonographically guided fine-needle biopsy of thyroid nodules:the effects of nodule characteristics, sampling technique, and needle size on the adequacy o cytological material[J]. Clin Radiol, 2007, 62(8):798-803.
2 .张琼,彭玉兰,马步云,等.甲状腺结节大小对超声引导细针抽吸细胞学检查有效率的影响[J].中国普外基础与临床杂志, 2015,22(7):832-835.ZHANG Qiong, PENG Yulan, MA Buyun, et al. Effect on efficiency of tyroid nodules’ size for ultrasound-guided fine-needle aspiration biopsy[J]. Chinese Journal of Bases and Clinics in General Surgery,2015, 22(7):832-835.
3.Haugen BR, Alexander EK, Bible KC, et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodulesanddifferentiatedthyroidcancer:theamericanthyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer[J]. Thyroid, 2016, 26(1):1-133.
4 .Gümü?M, Cay N, Algin O, et al. Comparison of 21 and 27 gauge needles for determining sample adequacy in the aspiration biopsy o thyroid nodules[J]. Diagn Interv Radiol, 2012, 18(1):102-105.
5 .Zhang L, Liu Y, Tan X, et al. Comparison of different-gauge needles fo fine-needle aspiration biopsy of thyroid nodules[J]. J Ultrasound Med2018, 37(7):1713-1716.
6 .梁淑琴.彩色多普勒超声对甲状腺结节的诊断价值研究[J].实用心脑肺血管病杂志, 2013, 21(5):135-136.LIANGShuqin.ThevalueofcolorDopplerultrasoundinthe diagnostic of thyroid nodules[J]. Practical Journal of Cardiac Cerebra Pneumal and Vascular Disease, 2013, 21(5):135-136.
7 .Grani G, Calvanese A, Carbotta G, et al. Intrinsic factors affecting adequacy of thyroid nodule fine-needle aspiration cytology[J]. Clin Endocrinol(Oxf), 2013, 78(1):141-144.
8 .冯伶艳,钱林学,刘玉江,等. 21G和23G细针对超声引导下甲状腺结节穿刺标本满意率的比较[J].中华医学超声杂志(电子版), 2015, 12(10):763-767.FENG Lingyan, QIAN Linxue, LIU Yujiang, et al. Comparison the samplesatisfactionrateof21and23gaugeneedlesusedforthe ultrasound-guided fine needle aspiration biopsy of thyroid nodules[J]Chinese Journal of Medical Ultrasound. Electronic Edition, 201512(10):763-767.
9 .DegirmenciB,HaktanirA,AlbayrakR,etal.Sonographically guided fine-needle biopsy of thyroid nodules:the effects of nodule characteristics, sampling technique, and needle size on the adequacy o cytological material[J]. Clin Radiol, 2007, 62(8):798-803.