南方医科大学学报

南方医科大学学报 ›› 2020, Vol. 40 ›› Issue (05): 693-697.doi: 10.12122/j.issn.1673-4254.2020.05.12

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超声引导下细针穿刺细胞学检测不同大小可疑甲状腺癌结节的阳性率及准确率

赵美丽，杨 炜，李金凤，王自正，邵国强   

  • 出版日期:2020-05-20 发布日期:2020-05-20
  • 基金资助:

Positive rate and accuracy of ultrasound-guided fine-needle aspiration cytology for detecting suspected thyroid carcinoma nodules of different sizes

  

  • Online:2020-05-20 Published:2020-05-20

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摘要： 目的 对不同大小可疑甲状腺癌结节行超声引导下细针穿刺（US-FNA）细胞学检测的结果进行阳性率、准确率、阳性预测值、阴性预测值统计分析，为临床医生选择US-FNA目标结节提供参考。方法 对591个患者的594个甲状腺可疑恶性 结节进行US-FNA细胞学检测，按结节大小将其分为4~5 mm组（Ⅰ组），6~10 mm组（Ⅱ组），>10 mm组（Ⅲ组），以术后病理为标准，统计出3组FNA细胞学检测结果阳性率（结果为甲状腺癌表示为阳性）、准确率、FNA取材病理诊断不能确诊率、阳性预测值、阴性预测值，比较其组间统计学差异。结果 Ⅰ组、Ⅱ组、Ⅲ组阳性率分别是39.2%（40/102），48.2%（172/357），65.2%（88/135），Ⅰ组与Ⅱ组比较无统计学差异（P=0.107），Ⅰ组与Ⅲ组、Ⅱ组与Ⅲ组比较有明显统计学差异（P分别0.000，0.001）；Ⅰ、Ⅱ、Ⅲ组准确率、病理不能确诊率、阳性预测值、阴性预测值分别为95.5%（21/22），97.1%（100/103），94.4%（51/54）；2.9%（3/102），2.8%（10/357），1.5%（2/135）；100%，100%，98%；66.7%，57.1%，33.3%，组间两两比较均未见统计学差异。结论 超声引导下FNA细胞学诊断甲状腺癌，结节大小对阳性率有一定影响，但对准确性、FNA取材细胞学不能确诊率、阳性预测值及阴性预测值均没有明显影响。

Abstract: Objective To analyze the accuracy and positive rate of ultrasound-guided fine-needle aspiration (US-FNA) cytology for detecting suspected thyroid cancer nodules of different sizes. Methods A total of 591 patients with 594 suspected malignant thyroid nodules received examinations with US-FNA cytology. Based on their size, the nodules were divided into group I (4-5 mm), group II (6-10 mm), group III (>10 mm). With the results of pathology as the standard, we analyzed the results of US-FNA cytology for detecting thyroid carcinoma in terms of its accuracy, indeterminate rate, positive predictive value and negative predictive value for nodules of different sizes. Results The positive rates in group I, group II and group III were 39.2% (40/102), 48.2% (172/357) and 65.2% (88/135), respectively, similar between groups I and II (P=0.107) and differed significantly between groups I and III (P=0.000) and between groups II and III (P=0.001). The accuracy, indeterminate rate, positive predictive value and negative predictive value in the 3 groups were 95.5% (21/22), 97.1% (100/103), and 94.4% (51/54); 2.9% (3/102), 2.8% (10/357), and 1.5% (2/135); 100% , 100% , and 98% ; 66.7% , 57.1% , and 33.3% , respectively, showing no significant differences among the 3 groups. Conclusion The size of the thyroid nodules can affect the positive rate but does not have significant effects on the accuracy, indeterminate rate, positive predictive value or negative predictive value of US-FNA cytology