超声引导下甲状腺细针穿刺在甲状腺疾病诊治中的临床应用评价
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国家自然科学基金(30671010,30971405);国家临床重点专科资助


Clinical significance of ultrasound-guided fine-needle aspiration biopsy for diagnosing thyroid diseases
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    目的:提高超声引导下甲状腺细针穿刺(US-FNAB)对于甲状腺疾病的诊断水平-方法:回顾性分析南京医科大学第一附属医院内分泌科2011年5月~2012年1月1 016份US-FNAB细胞病理报告,同时对比分析其中44例接受外科手术患者的组织病理报告-结果:1 016例报告中怀疑或确定为恶性肿瘤72例(7.09%),132例诊断为甲状腺囊性变,占12.99%-明确诊断慢性淋巴细胞性甲状腺炎165例(16.24%)-亚急性甲状腺炎56例(5.51%)-对44例接受手术患者的资料进一步分析得出,US-FNAB对于恶性或怀疑为恶性疾病诊断的敏感性为65.22%,特异性为76.19%,阳性预测值为75.00%,阴性预测值为66.67%,假阳性率为25.00%,假阴性率为33.33%-总体阳性细胞率85.24%-结论:US-FNAB对于甲状腺良恶性结节的鉴别,对于甲状腺囊性变-慢性淋巴细胞性甲状腺炎-亚急性甲状腺炎的细胞病理诊断有非常重要的价值-

    Abstract:

    Objective:To improve the capability of ultrasound-guided fine-needle aspiration biopsy (US-FNAB) in diagnosing thyroid diseases. Methods:Total 1 016 US-FNAB cytopathological cases were analyzed retrospectively from May 2011 to Jan 2012 in Department of Endocrinology,the First Affiliated Hospital of NJMU. Meantime,44 histological pathological reports from these patients were analyzed. Results:Among 1 016 US-FNAB cytopathological reports,72 cases (7.09%) were labelled as malignant or suspicious for malignancy while confirmative cytopathological diagnosis for capsula glandulae thyroideae,chronic lymphocytic thyroiditis (CLT) and subacute thyroiditis were seen in 132 (12.99%),165 (16.24%),and 56 (5.51%) cases. By combining cytological result of US-FNAB and histological pathological results of sugery,the sensitivity,specificity,positive predictive value,negative predictive value,false positive rate and false negative rate were calculated as following 65.22%,76.19%,75.00%,66.67%,25.00% and 33.33%. Total positive cell rate was 85.24%. Conclusion:US-FNAB showed great importance in differentiation between benign and malignant thyroid lesions and in diagnosing capsula glandulae thyroideae,chronic lymphocytic thyroiditis and subacute thyroiditis.

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刘晓云,陈欢欢,戎 荣,吴云松,段 宇,魏 玲,蒋 琳,唐 伟,武晓泓,杨 涛.超声引导下甲状腺细针穿刺在甲状腺疾病诊治中的临床应用评价[J].南京医科大学学报(自然科学版),2012,(6):831-836

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  • 收稿日期:2012-01-13
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