超声引导下甲状腺细针穿刺细胞涂片对4A类甲状腺结节良恶性的鉴别诊断价值

doi:10.3760/cma.j.issn.1007-1245.2023.15.021

摘要/Abstract

摘要：

目的　分析超声引导下甲状腺细针穿刺细胞涂片对4A类甲状腺结节良恶性的鉴别诊断价值。方法　本研究纳入2021年1月至2023年1月拟于聊城市第三人民医院接受手术治疗并且超声提示4A类甲状腺结节患者80例（共114个结节），其中男35例，女45例，年龄（42.54±10.54）岁。患者均于术前接受超声引导下甲状腺细针穿刺细胞涂片。另将患者术后病理检查结果记为“金标准”，统计甲状腺结节中的良性和恶性占比；观察经超声引导下甲状腺细针穿刺细胞涂片后甲状腺恶性结节的检出率；分析超声引导下甲状腺细针穿刺细胞涂片对4A类甲状腺结节的诊断价值。采用Kappa一致性检验。结果　经术后病理证实结果，患者的所有结节中，良性结节36个，占比为31.58%（36/114），主要包括：桥本甲状腺炎1个，腺瘤样增生2个，皱缩结节6个，亚急性甲状腺炎9个，结节性甲状腺肿18个。患者的所有结节中，恶性结节78个，占比为68.42%（78/114），主要包括：乳头状癌73个，髓样癌5个。经Kappa一致性检验发现，超声引导下甲状腺细针穿刺细胞涂片对4A类甲状腺恶性结节的检出情况与“金标准”结果一致性良好（Kappa值=0.802，P<0.05）。超声引导下甲状腺细针穿刺细胞涂片诊断4A类甲状腺恶性结节的灵敏度为80.77%，特异度为75.00%。结论　4A类甲状腺结节中的恶性结节占比较高，采用超声引导下甲状腺细针穿刺细胞涂片对4A类甲状腺恶性结节具有较高的诊断价值，适合临床推广应用。

关键词:

4A类甲状腺结节, 超声引导, 甲状腺细针穿刺细胞涂片, 良恶性, 鉴别诊断

Abstract:

Objective　To analyze the value of ultrasound-guided thyroid fine needle puncture smear in the differential diagnosis of benign and malignant thyroid nodules of 4A type. Methods　This study included 80 patients with 4A thyroid nodules indicated by ultrasound who were scheduled to receive surgical treatment in Liaocheng Third People's Hospital from January 2021 to January 2023, with a total of 114 nodules. There were 35 males and 45 females, with an age of (42.54±10.54) years old. All patients received ultrasound-guided thyroid fine needle puncture smear before surgery. In addition, the patients' postoperative pathological examination results were recorded as "gold standard", and the proportion of benign and malignant thyroid nodules was calculated. The detection rate of malignant thyroid nodules by ultrasound-guided thyroid fine needle puncture smear was observed. The value of ultrasound-guided thyroid fine needle puncture smear in the diagnosis of 4A thyroid nodules was analyzed. Kappa consistency test was adopted. Results　The pathological results showed that 36 nodules were benign, accounting for 31.58% (36/114), including 1 Hashimoto's thyroiditis, 2 adenomatous hyperplasia, 6 crinkled nodules, 9 subacute thyroiditis, and 18 nodular goiter; 78 nodules were malignant, accounting for 68.42% (78/114), including 73 papillary carcinoma and 5 medullary carcinoma. Kappa consistency test showed that the detection of 4A malignant thyroid nodules by ultrasound-guided thyroid fine needle puncture smear was in good agreement with the "gold standard" results (Kappa value = 0.802, P<0.05). The sensitivity and specificity of ultrasound guided thyroid fine needle puncture smear in the diagnosis of 4A malignant thyroid nodules were 80.77% and 75.00%. Conclusions　Malignant nodules account for a relatively high proportion of 4A thyroid nodules. The ultrasound-guided thyroid fine needle puncture smear has a high diagnostic value for 4A malignant thyroid nodules, which is suitable for clinical application.

Key words:

4A thyroid nodules, Ultrasonic guidance, Thyroid fine needle puncture smear, Benign and malignant, Differential diagnosis

谢丽赵昌乾王媛媛刘海娟.

超声引导下甲状腺细针穿刺细胞涂片对4A类甲状腺结节良恶性的鉴别诊断价值 [J]. 国际医药卫生导报, 2023, 29(15): 2158-2162.

Xie Li, Zhao Changqian, Wang Yuanyuan, Liu Haijuan.

Value of ultrasound-guided thyroid fine needle puncture smear in the differential diagnosis of benign and malignant thyroid nodules of 4A type [J]. International Medicine and Health Guidance News, 2023, 29(15): 2158-2162.

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