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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 cytological and histological findings of patients undergoing thyroidectomy for thyroid nodules and investigate the diagnostic value of fine needle aspiration cytology (FNA) for thyroid nodules. Methods A total of 89 patients with thyroid nodules who were admitted to our hospital from May 2005 to December 2008 were collected. Fine needle aspiration cytology and thyroidectomy were performed successively to analyze and compare the results. Results The postoperative pathological diagnosis of nodular surgeries performed in 89 patients with FNA was the gold standard. The accuracy of fine needle aspiration cytology was 85.7%, the specificity was 90.2% and the diagnostic accuracy was 88.8%. Fine needle aspiration cells The overall diagnostic coincidence rate of examination and histopathological examination was 88.8%, and the coincidence rate of fine needle aspiration cytology and histopathological examination of nodular goiter, papillary thyroid carcinoma and medullary carcinoma was high, followed by 98.1%, 84% and 100%, respectively. There was no significant difference between the two groups in the overall diagnostic accuracy rate. The coincidence rate was only 11.1% for the diagnosis of follicular adenoma, which was significantly different from the overall diagnostic coincidence rate Statistical significance (P <0.05). Conclusion Fine needle aspiration cytology is more valuable for the diagnosis of benign and malignant nodules. The coincidence rate is good with the overall diagnosis of histopathological examination. However, the diagnostic accuracy of fine needle aspiration biopsy is low, and the diagnosis of nodular nature should be combined with the symptoms and signs , Ultrasound, isotope scanning and fine needle aspiration results combined judgment.