川北医学院学报2024，Vol.39Issue(8)：1030-1035,6.DOI:10.3969/j.issn.1005-3697.2024.08.006
细针穿刺、粗针穿刺及两者联合诊断甲状腺结节的前瞻性对比研究
A prospective comparative study of fine needle aspiration,coarse needle biopsy,and their combination in the diagnosis of thyroid nodules
摘要
Abstract
Objective:To compare and analyze the diagnostic efficacy of ultrasound(US)guided fine needle aspiration(FNA),coarse needle biopsy(CNB),and combination of coarse and fine needle aspiration(FNA+CNB)for the same thyroid nodule.Meth-ods:105 patients with thyroid nodules(112 nodules)were selected,and ultrasound guided fine needle(FNA)and coarse needle(CNB)puncture were performed simultaneously on each nodule.The diagnostic efficacy of FNA,CNB,and FNA+CNB for thyroid nodules was compared,respectively.Grouping based on ultrasound features(maximum diameter of nodules,coarse calcification,aspect ratio,and cystic solidity)to compare the diagnostic accuracy of FNA and CNB.Results:After removing 14 failed puncture nodules,the remaining 98 nod-ules entered the study.The success rates for FNA and CNB puncture sampling were 89.4％and 97.3％,respectively(P＜0.05).The sensitivity of FNA,CNB,and FNA+CNB were 93.1％,75.9％,and 100％,respectively,FNA and FNA+CNB were better than CNB(P＜0.05).The specificity was 60％,90％,and 57.5％,respectively,CNB was superior to FNA and FNA+CNB(P＜0.05).The nega-tive predictive values were 85.7％,72％,and 100％,respectively,and FNA+CNB was superior to CNB(P＜0.05).ROC curve analysis showed that the area under curve(AUC)of the CNB was greater than FNA(0.829 vs.0.766,P＜0.05).In subgroup analysis,the diag-nostic specificity of CNB was higher than that of FNA(100％vs.50％,P=0.014)and the diagnostic sensitivity of FNA was higher than that of CNB(93.3％vs.46.7％,P=0.033)for nodules＜0.5 cm in diameter.The size and aspect ratio of nodules may affect the diag-nosis of CNB,the sensitivity of d≥0.5 cm was better,and the accuracy of aspect ratio≤1 was higher(P＜0.05).The cystic and solid nodules may affect the FNA diagnosis,and solid nodules had higher accuracy(P＜0.05).Conclusion:CNB is more valuable in diagno-sing thyroid gland nodules,but FNA is more sensitive for nodules less than 0.5 cm in diameter.关键词
甲状腺结节/粗针穿刺/穿刺/超声/细针穿刺/诊断价值Key words
Thyroid nodules/Coarse needle biopsy/Puncture/Ultrasound/Fine needle aspiration/Diagnostic value分类
医药卫生引用本文复制引用
陈芳,赵小波,侯令密,高砚春,陈虹羽..细针穿刺、粗针穿刺及两者联合诊断甲状腺结节的前瞻性对比研究[J].川北医学院学报,2024,39(8):1030-1035,6.基金项目
四川省自然科学基金面上项目(2022NSFSC0775) （2022NSFSC0775）
