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南京医科大学学报(自然科学版) 第43卷第8期
·1140 · Journal of Nanjing Medical University(Natural Sciences) 2023年8月
·临床研究·
穿刺针型号及甲状腺结节超声特征对超声引导下细针穿刺活
检标本取材满意率的影响
张中原 ,杨艳丽 ,王加林 ,陈雁群 ,刘 梦 ,崔 岱 1*
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南京医科大学第一附属医院内分泌科,江苏 南京 210029;东南大学医学院附属南京同仁医院甲状腺中心,病理科,江
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苏 南京 211102
[摘 要] 目的:探讨不同穿刺针型号及结节超声特征对甲状腺结节细针穿刺标本取材满意率的影响。方法:纳入 2020 年
8月—2022年8月在南京同仁医院行细针穿刺活检的185例甲状腺结节患者(185个结节),所有结节均接受23G和25G超声引
导下细针穿刺抽吸活组织检查(ultrasound⁃guided fine needle aspiration biopsy,US⁃FNAB)。根据其超声特征(结节大小、粗大钙
化、血供、回声)进行分组,穿刺标本依据Bethesda 甲状腺细胞病理学报告系统(the Bethesda system for reporting thyroid cytopa⁃
thology,TBSRTC)诊断分类分为取材满意和不满意两类,分析穿刺针型号及结节的超声特征对穿刺标本取材满意率的影响。
结果:23G组和25G组总体标本取材满意率无统计学差异(85.4% vs. 88.1%,P=0.443)。根据结节最大径分3组,≤0.5 cm组标本
取材满意率低于0.5~1.0 cm、≥1.0 cm两组(P < 0.05)。根据结节钙化分为粗大钙化组和其他组,23G细针在粗大钙化组中的标
本取材满意率高于25G细针(76.5% vs. 52.9%,P < 0.05),在其他组两种细针的标本取材满意率无统计学差异。根据血供情况
分为血供丰富组和乏血供组,25G细针在血供丰富组标本取材满意率高于23G细针(83.3% vs. 61.9%,P < 0.05),在乏血供组两
种细针的标本取材满意率无统计学差异。根据结节回声分为低回声组、等回声组、高回声组,23G与25G细针在不同回声组之
间比较,差异无统计学意义(P>0.05)。结论:甲状腺结节较小(最大径≤0.5 cm)、伴有粗大钙化或血供丰富均会影响标本的取
材满意率。
[关键词] 甲状腺结节;超声引导细针穿刺;超声特征
[中图分类号] R445.1 [文献标志码] A [文章编号] 1007⁃4368(2023)08⁃1140⁃05
doi:10.7655/NYDXBNS20230815
Influence of puncture needle type and ultrasonic characteristics of thyroid nodules on the
sampling satisfaction rate of ultrasound⁃guided fine needle biopsy specimen
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ZHANG Zhongyuan ,YANG Yanli ,WANG Jialin ,CHENG Yanqun ,LIU Meng ,CUI Dai 1*
Department of Endocrinology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029;
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2 Department of Thyroid,Department of Pathology,Nanjing Tongren Hospital Affiliated Medical College of Southeast
University,Naijing 211102,China
[Abstract] Objective:To investigate the influence of different puncture needle types and ultrasonic characteristics of thyroid
nodules on the sampling satisfaction rate of ultrasound⁃guided fine needle biopsy specimen. Methods:A total of 185 patients with
thyroid nodules(185 nodules)who underwent fine⁃needle aspiration biopsy in Nanjing Tongren Hospital between August 2020 and
August 2022 were included. All nodules received 23 G and 25 G ultrasound guided fine⁃needle aspiration biopsy. According to nodular
ultrasonic characteristics(nodule size,coarse calcification,blood supply,echo),puncture specimens were classified into satisfactory
and unsatisfactory categories according to the Bethesda system for reporting thyroid cytopathology . The influence of puncture needle
types and nodular ultrasonic characteristics on the sampling satisfaction rate were evaluated. Results:There was no statistical
difference in the overall sampling satisfaction rate between the 23 G group and the 25 G group(85.4% vs. 88.1% ,P=0.443).
According to the maximum diameter,the nodules were divided into three groups. The satisfactory rate of specimen collection in the
[基金项目] 中国健康促进基金会2020甲状腺中青年医生项目
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通信作者(Corresponding author),E⁃mail:cui_dai@163.com