甲状腺结节超声特征参数对细针穿刺诊断效能影响的分析

彭婵娟; 杨琛; 时开元; 冯娜; 潘蔚芸

doi:10.16766/j.cnki.issn.1674-4152.2016.09.035

甲状腺结节超声特征参数对细针穿刺诊断效能影响的分析

doi: 10.16766/j.cnki.issn.1674-4152.2016.09.035

浙江省肿瘤医院超声科, 浙江杭州 310022

基金项目:

浙江省医药卫生科技计划项目(2015KYB057)

详细信息

通讯作者:
杨琛,E-mail:carriey918@sina.com

中图分类号: R445.1;R581.3
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出版历程
- 收稿日期: 2015-09-25

Analysis of diagnostic efficacy of fine-needle aspiration for ultrasonic parameters of thyroid nodules

Department of Ultrasonography, Zhejiang Cancer Hospital, Hangzhou 310022, China

摘要

摘要: 目的探讨甲状腺结节超声特征参数大小、钙化对超声引导下细针穿刺抽吸(ultrasound-guided fine-needle aspiration,US-FNA)诊断效能的影响。方法回顾性分析2012～2014年行US-FNA的614例患者，根据结节最大径分为A组(≤5 mm)、B组(5～10 mm)、C组(＞10 mm)，以及根据钙化类型分为N组(无钙化)、Mi组(微钙化)、Ma组(粗钙化)。以Bethesda System评估US-FNA结果，同时应用受试者工作特征曲线(ROC)评价诊断效果。结果 ①A组FNA诊断甲状腺癌敏感性、特异性、准确率、阳性预测值、阴性预测值分别为92.1%、96.6%、94.0%、97.2%、90.3%；B组分别为91.1%、95.3%、93.0%、96.3%、89.1%；C组分别为93.6%、96.2%、95.1%、94.8%、95.2%，3组间敏感性、特异性、准确率、阳性预测值、阴性预测值比较差异均无统计学意义(P＞0.05)。N组FNA诊断甲状腺癌敏感性、特异性、准确率、阳性预测值、阴性预测值分别为90.9%、96.3%、93.6%、96.3%、90.9%；Mi组分别为93.5%、92.1%、93.0%、95.1%、89.7%；Ma组分别为96.6%、97.1%、96.8%、96.6%、97.1%，3组间各值比较差异均无统计学意义(P＞0.05)。②A、B、C组的ROC曲线下面积AUC分别为0.94、0.93、0.95，N、Mi、Ma组分别为0.94、0.93、0.97。结论 US-FNA对于大小不限、有无钙化的甲状腺结节均具有较高的诊断价值。
- 超声引导 /
- 细针穿刺抽吸 /
- 甲状腺结节 /
- 大小 /
- 钙化
Abstract: Objective To investigate diagnostic effectiveness of ultrasound-guided fine-needle aspiration(US-FNA) for the sonographic features of thyroid nodules like size and calcification. Methods A retrospective analysis of the clinical patients of 614 thyroid nodules from 2012 to 2014.According to the maximal diameter of thyroid nodules,the nodules were divided into group A(≤ 5 mm),B(5-10 mm),and C(>10 mm),and according to the calcification,the nodules were divided into group N(no calcification),group Mi(Microcalcification) and group Ma(Macrocalcification).By the Bethesda System,>grade IV was the malignant cytologic criteria for diagnosis of thyroid nodules.At the same receiver operating characteristic curve was to evaluate the diagnosis of size and calcification between groups. Results ①In group A,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of US-FNA were 92.1%,96.6%,94.0%,97.2%,and 90.3%.In group B,they were 91.1%,95.3%,93.0%,96.3%,and 89.1%.In group C,they were 93.6%,96.2%,95.1%,94.8% and 95.2%,respectively.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of the three groups showed no significant difference(P>0.05).In group N,they were 93.6%,96.4%,93.6%,96.3% and 90.9%.In group Mi,they were 89.5%,88.9%,93.0%,95.1% and 89.7%,and in group Ma,they were 96%,97.1%,96.8%,96.6% and 97.1%,respectively.The three groups also show no significant difference(P>0.05).②AUC of group A,B,and C were 0.94,0.93,and 0.95,while group N,Mi,and Ma were 0.94,0.93,and 0.97. Conclusion US-FNA is not limited to the size,calcification of thyroid nodules,but have high diagnostic value.
- Ultrasound-guided /
- Fine-needle aspiration /
- Thyroid nodule /
- Size /
- Calcification