超声与细针穿刺诊在甲状腺结节诊断中的价值比较
|
摘要
目的对比研究超声与细针穿刺对甲状腺结节的诊断价值。方法回顾性对比分析我院193例甲状腺结节的超声及细针穿刺的结果,评估超声及细针穿刺对甲状腺结节诊断的符合率及应用价值。结果 193例甲状腺结节中,超声诊断为甲状腺癌97例(50.3%),良性病变共96例(49.7%);而针穿刺细胞学诊断为甲状腺癌共71例(36.8%),良性病变107例(55.4%),可疑癌变15例(7.8%)。在超声诊断的97例甲状腺癌中,与细针穿刺相符合的为63例(64.9%),不符合的为22例(22.7%),可疑癌变为12例(12.4%),而在超声诊断的96良性病变中,与细针穿刺相符合的为85例(88.5%),不符合的为8例(8.3%),可疑癌变为3例(3.1%),二者之间的差异具有统计学意义(P=0.001)。结论超声与细针穿刺均有助于甲状腺结节的诊断,并具有一定的符合度,其中超声对甲状腺良性病变的诊断明显优于甲状腺癌。
Objective To compare the diagnostic value of ultrasonography and fine needle aspiration in thyroid nodules.Methods A total of 193 patients with thyroid nodules received ultrasound and fine needle aspiration were enrolled and retrospectively analyzed. The coincidence rate and application value of ultrasonography and fine needle aspiration in the diagnosis of thyroid nodules were evaluated. Results In 193 cases of thyroid nodules, 97 cases(50.3%) were diagnosed of thyroid carcinoma and 96 cases(49.7%) of benign lesions based on the ultrasonography detection. However, 71 cases(36.8%)were diagnosed of thyroid carcinoma, 107 cases(55.4%) of benign lesions and 15 cases(7.8%) of suspicious cancer, according to the fine needle aspiration. Among the 97 cases with thyroid cancers diagnosed by ultrasonography, 63 cases(64.9%) were matched with fine needle aspiration, 22 cases(22.7%) were not met, and 12 cases(12.4%) were suspected. In 96 cases with benign lesions diagnosed by ultrasound, 85 cases(88.5%) were consistent with fine needle aspiration, 8 cases(8.3%) were not met, 3 cases(3.1%) were suspected, and the difference was significant(P=0.001). Conclusion Both ultrasonography and fine needle aspiration are contributed to the diagnosis of thyroid nodules with a certain degree of compliance. However,ultrasound is better in the diagnosis of thyroid benign lesions than in thyroid cancer.
Objective To compare the diagnostic value of ultrasonography and fine needle aspiration in thyroid nodules.Methods A total of 193 patients with thyroid nodules received ultrasound and fine needle aspiration were enrolled and retrospectively analyzed. The coincidence rate and application value of ultrasonography and fine needle aspiration in the diagnosis of thyroid nodules were evaluated. Results In 193 cases of thyroid nodules, 97 cases(50.3%) were diagnosed of thyroid carcinoma and 96 cases(49.7%) of benign lesions based on the ultrasonography detection. However, 71 cases(36.8%)were diagnosed of thyroid carcinoma, 107 cases(55.4%) of benign lesions and 15 cases(7.8%) of suspicious cancer, according to the fine needle aspiration. Among the 97 cases with thyroid cancers diagnosed by ultrasonography, 63 cases(64.9%) were matched with fine needle aspiration, 22 cases(22.7%) were not met, and 12 cases(12.4%) were suspected. In 96 cases with benign lesions diagnosed by ultrasound, 85 cases(88.5%) were consistent with fine needle aspiration, 8 cases(8.3%) were not met, 3 cases(3.1%) were suspected, and the difference was significant(P=0.001). Conclusion Both ultrasonography and fine needle aspiration are contributed to the diagnosis of thyroid nodules with a certain degree of compliance. However,ultrasound is better in the diagnosis of thyroid benign lesions than in thyroid cancer.
引文
[1]He YP,Xu HX,Zhao CK,et al.Cytologically indeterminate thyroid nodules:increased diagnostic performance with combination of US TI-RADS and a new scoring system[J].Sci Rep,2017,7(1):6906-14.
[2]代文杰,徐德全,殷越.甲状腺结节手术范围合理选择--美国及我国相关指南解读[J].中国实用外科杂志,2015,35(6):604-7.
[3]刘娟,吴凤林,隋洋,等.超声引导下经皮激光消融甲状腺良性实性结节[J].南方医科大学学报,2013,33(10):1529-32.
[4]杨英,魏枫,薛晔霞.甲状腺结节细针穿刺细胞学检查与TI-RADS的价值分析[J].中华临床医师杂志:电子版,2016,10(17):2547-51.
[5]邵礼成,菅洪健,陈广辉,等.中青年分化型型甲状腺癌患者术后复发与生存分析[J].南方医科大学学报,2017,37(2):274-7.
[6]Haugen BR,Alexander EK,Bible KC,et al.2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer:the American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer[J].Thyroid,2016,26(1):1-133.
[7]Lee SH,Kim MH,Bae JS,et al.Clinical outcomes in patients with Non-Diagnostic thyroid fine needle aspiration cytology:usefulness of the thyroid core needle biopsy[J].Ann Surg Oncol,2014,21(6):1870-7.
[8]Allelein S,Feldkamp J,Schott M.Current diagnostics and treatment of thyroid nodules[J].Dtsch Med Wochenschr,2017,142(15):1097-100.
[9]Gharib H,Papini E,Paschke R,et al.American association of clinical endocrinologists,associazione medici endocrinologi,and European thyroid association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules:executive summary of recommendations[J].Endocr Pract,2010,16(3):468-75.
[10]Nayar R,Ivanovic M.The indeterminate thyroid fine-needle aspiration:Experience from an academic center using terminology similar to that proposed in the 2007 National cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference[J].Cancer,2009,117(3):195-202.
[11]Yassa L,Cibas ES,Benson CB,et al.Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation[J].Cancer,2007,111(6):508-16.
[12]钟丽佳,黄艳红,沈志云,等.超声造影诊断甲状腺癌的临床价值[J].中国耳鼻咽喉头颈外科,2017,24(2):63-6.
[13]郑斌,詹维伟,倪晓枫,等.超声引导下细针穿刺抽吸活检对TI-RADS 4类甲状腺结节的诊断价值[J].上海交通大学学报:医学版,2014,34(8):1206-9.
[14]Ucler R,Usluogullari CA.The diagnostic accuracy of ultrasoundguided fine-needle aspiration biopsy for thyroid nodules three centimeters or larger in size[J].Diagn Cytopathol,2015,43(8):622-8.
[15]Zahir ST,Vakili M,Ghaneei A,et al.Ultrasound assistance in differentiating malignant thyroid nodules from benign Ones[J].JAyub Med Coll Abbottabad,2016,28(4):644-9.
[16]Ma S,Zhou P,Wu X,et al.Detection of the Single-Session complete ablation rate by Contrast-Enhanced ultrasound during Ultrasound-Guided laser ablation for benign thyroid nodules:a prospective study[J].Biomed Res Int,2016,32(2016):9565364-71.
[17]Khalife S,Bouhabel S,Forest V,et al.The McGill thyroid nodule score's(MTNS plus)role in the investigation of thyroid nodules with benign ultrasound guided fine needle aspiration biopsies:a retrospective review[J].J Otolaryngol Head Neck Surg,2016,45(1):29-35.
[18]Bak M,Peter I,Nyari T,et al.On-site fine-needle aspiration cytology of thyroid nodules(2008)[J].Orv Hetil,2015,156(41):1661-6.
[19]Alves ML,Gabarra MH.Comparison of power doppler and thermography for the selection of thyroid nodules in which fineneedle aspiration biopsy is indicated[J].Radiol Bras,2016,49(5):311-5.
[2]代文杰,徐德全,殷越.甲状腺结节手术范围合理选择--美国及我国相关指南解读[J].中国实用外科杂志,2015,35(6):604-7.
[3]刘娟,吴凤林,隋洋,等.超声引导下经皮激光消融甲状腺良性实性结节[J].南方医科大学学报,2013,33(10):1529-32.
[4]杨英,魏枫,薛晔霞.甲状腺结节细针穿刺细胞学检查与TI-RADS的价值分析[J].中华临床医师杂志:电子版,2016,10(17):2547-51.
[5]邵礼成,菅洪健,陈广辉,等.中青年分化型型甲状腺癌患者术后复发与生存分析[J].南方医科大学学报,2017,37(2):274-7.
[6]Haugen BR,Alexander EK,Bible KC,et al.2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer:the American thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer[J].Thyroid,2016,26(1):1-133.
[7]Lee SH,Kim MH,Bae JS,et al.Clinical outcomes in patients with Non-Diagnostic thyroid fine needle aspiration cytology:usefulness of the thyroid core needle biopsy[J].Ann Surg Oncol,2014,21(6):1870-7.
[8]Allelein S,Feldkamp J,Schott M.Current diagnostics and treatment of thyroid nodules[J].Dtsch Med Wochenschr,2017,142(15):1097-100.
[9]Gharib H,Papini E,Paschke R,et al.American association of clinical endocrinologists,associazione medici endocrinologi,and European thyroid association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules:executive summary of recommendations[J].Endocr Pract,2010,16(3):468-75.
[10]Nayar R,Ivanovic M.The indeterminate thyroid fine-needle aspiration:Experience from an academic center using terminology similar to that proposed in the 2007 National cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference[J].Cancer,2009,117(3):195-202.
[11]Yassa L,Cibas ES,Benson CB,et al.Long-term assessment of a multidisciplinary approach to thyroid nodule diagnostic evaluation[J].Cancer,2007,111(6):508-16.
[12]钟丽佳,黄艳红,沈志云,等.超声造影诊断甲状腺癌的临床价值[J].中国耳鼻咽喉头颈外科,2017,24(2):63-6.
[13]郑斌,詹维伟,倪晓枫,等.超声引导下细针穿刺抽吸活检对TI-RADS 4类甲状腺结节的诊断价值[J].上海交通大学学报:医学版,2014,34(8):1206-9.
[14]Ucler R,Usluogullari CA.The diagnostic accuracy of ultrasoundguided fine-needle aspiration biopsy for thyroid nodules three centimeters or larger in size[J].Diagn Cytopathol,2015,43(8):622-8.
[15]Zahir ST,Vakili M,Ghaneei A,et al.Ultrasound assistance in differentiating malignant thyroid nodules from benign Ones[J].JAyub Med Coll Abbottabad,2016,28(4):644-9.
[16]Ma S,Zhou P,Wu X,et al.Detection of the Single-Session complete ablation rate by Contrast-Enhanced ultrasound during Ultrasound-Guided laser ablation for benign thyroid nodules:a prospective study[J].Biomed Res Int,2016,32(2016):9565364-71.
[17]Khalife S,Bouhabel S,Forest V,et al.The McGill thyroid nodule score's(MTNS plus)role in the investigation of thyroid nodules with benign ultrasound guided fine needle aspiration biopsies:a retrospective review[J].J Otolaryngol Head Neck Surg,2016,45(1):29-35.
[18]Bak M,Peter I,Nyari T,et al.On-site fine-needle aspiration cytology of thyroid nodules(2008)[J].Orv Hetil,2015,156(41):1661-6.
[19]Alves ML,Gabarra MH.Comparison of power doppler and thermography for the selection of thyroid nodules in which fineneedle aspiration biopsy is indicated[J].Radiol Bras,2016,49(5):311-5.