摘要
目的通过比较甲状腺结节穿刺后手术患者细胞学与组织学检查结果,探讨细针穿刺细胞学检查(FNA)对甲状腺结节的诊断价值。方法收集2005年5月-2008年12月我院住院期间收治甲状腺结节患者89例,先后予以甲状腺细针穿刺细胞学检查及手术切除物组织病理学检查,分析比较检查结果。结果以89例FNA后完成结节手术者的术后病理学诊断为金标准,细针穿刺细胞学诊断敏感性为85.7%,特异性为90.2%,诊断准确率为88.8%;细针穿刺细胞学检查与组织病理学检查结果总体诊断符合率为88.8%,其中对结节性甲状腺肿,甲状腺乳头状癌、髓样癌细针穿刺细胞学检查与组织病理学检查诊断符合率较高,依次为98.1%、84%、100%,与总体诊断符合率相比差异无统计学意义;对滤泡性腺瘤两者诊断符合率较低,仅为11.1%,与总体诊断符合率相比差异有统计学意义(P<0.05)。结论细针穿刺细胞学检查对结节良恶性诊断价值较高,与组织病理学检查总体诊断符合率较好,但对滤泡性腺瘤诊断符合率较低,对结节性质判定应结合症状体征、超声、同位素扫描及细针穿刺结果综合判断。
Objective To compare the results of cytology and histopathology in the patients who had an operation of fine needle aspiration biopsy （FNA） and thyroidectomy, and to assess the clinical value of fine needle aspiration biopsy in the diagnosis of thyroid nodule. Methods Eighty- nine inpatients with thyroid nodule in our hospital from May, 2.005 to December, 2008 were selected to perform fine needle aspiration biopsy and thyroidectomy, and the results of the two examination methods were compared. Results With the diagnosis of histopathology as ＂gold standard＂, the sensitivity, specificity, and diagnostic accuracy of FNA were 85.7 %, 90.2 %, and 88.8 %. The total diagnostic accordance rate of fine needle aspiration biopsy was 88.8 % as compared with that of histopathology. The diagnostic accordance rates of nodular goiter, thyroid palillary carcinoma and carcinoma medullar were 98.1%, 84 % and 100 % respectively, which had no statistical difference as compare with the total diagnostic accordance rate. The accordance rate of the two methods in dignosis of thyroid follicular adenoma was only 11. 1 %, which had a statistical difference as compared with the total diagnostic accordance rate （P〈 0.05）. Conclusions The diagnostic value of fine needle aspiration biopsy is high, and most of thyroid nodules have high total diagnostic accordance rate, but not thyroid follicular adenoma. It is important to utilize all the clinical data including clinical symptoms and objective signs, ultrasonography, scintigraphy and FNA in diagnosis of thyroid nodules.
出处
《实用预防医学》
CAS
2009年第5期1549-1550,共2页
Practical Preventive Medicine
关键词
甲状腺结节
诊断
细针穿刺
细胞学
组织病理学
Thyroid nodule
Diagnosis
Fine needle aspiration
Cytology
Histopathology
