The Diagnostic Accuracy of Ultrasound-Guided Fine-Needle Aspiration Biopsy and the Sonographic Differences Between Benign and Malignant Thyroid Nodules 3 cm or Larger
The Diagnostic Accuracy of Ultrasound-Guided Fine-Needle Aspiration Biopsy and the Sonographic Differences Between Benign and Malignant Thyroid Nodules 3 cm or Larger
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DOI：
10.1089/thy.2010.0458
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发表时间：
2011-09-01
期刊：
影响因子：
6.6
通讯作者：
Kim, Eun-Kyung
中科院分区：
文献类型：
--
作者：
Yoon, Jung Hyun;Kwak, Jin Young;Kim, Eun-Kyung
背景资料：虽然细针穿刺活检（FNAB）被认为是甲状腺结节术前评估的标准，但对于大的甲状腺结节，其价值受到质疑。在此，我们评估了超声引导下FNAB（US-FNAB）对3 cm或以上甲状腺结节的诊断准确性，以及该尺寸组中良性和恶性结节之间的超声差异。材料与方法：从2002年2月至2006年12月，有661例甲状腺肿块等于或大于3 cm，接受了US-FNAB，并被纳入本研究。这些患者的细胞学和手术病理学读数与超声特征一起进行了沿着审查，最后一次由一名放射科医生进行回顾性审查。使用组织学计算US-FNAB细胞学读数的准确度参数。此外，可能的诊断为良性细胞学阅读患者进行了determined.Results：甲状腺手术的661结节在相同数量的患者（31.2%）的206。所有细胞学读数不充分、不确定或怀疑恶性肿瘤的受试者均接受了甲状腺手术。所有未行甲状腺手术的患者均被认为可能患有良性疾病，因为他们的初始细胞学阅读和随访，最终，587例（88.8%）为良性，74例（11.2%）为恶性。当考虑恶性、可疑恶性和不确定的细胞学读数为阳性，良性细胞学为阴性时，敏感性为96.7%，特异性为85.9%，阳性预测值为76.6%，阴性预测值为98.2%，准确性为89.4%。恶性甲状腺结节的超声特征比良性或可能为良性的甲状腺结节更常见（70.3% vs.1.2%，p < 0.001），良性结节的超声特征在良性或被认为可能是良性的甲状腺结节中比恶性结节更常见结论：在本研究中，US-FNAB是一种相对准确的方法来评估大于3cm的甲状腺结节，假阴性率约为2%。需要更大的系列来确定其在这种情况下的效用。
Background: Although fine-needle aspiration biopsy (FNAB) is considered the standard for preoperative evaluation of thyroid nodules, the value of this has been questioned for large thyroid nodules. Here, we evaluated the diagnostic accuracy of ultrasound-guided FNAB (US-FNAB) for thyroid nodules that were 3 cm or larger as well as the sonographic differences between benign and malignant nodules in this size group. Materials andMethods: There were 661 thyroid masses equal to or larger than 3 cm who underwent US-FNAB from February 2002 to December 2006 and were included in this study. The cytology and surgical pathology readings in these patients were reviewed along with the ultrasonography features, the last from the retrospective review by one radiologist. Histopathology was used to calculate accuracy parameters for the US-FNAB cytology readings. In addition, the likely diagnoses for patients with a benign cytology reading were ascertained.Results: Thyroid surgery was performed for 206 of the 661 nodules in the same number of patients (31.2%). All subjects who had inadequate, indeterminate, or suspicious for malignancy cytology readings had thyroid surgery. All of the patients who did not have thyroid surgery were considered likely to have benign disease because of their initial cytology reading and follow-up, and finally, 587 (88.8%) were benign and 74 (11.2%) were malignant. When considering malignant, suspicious for malignancy, and indeterminate cytology readings as positive and benign cytology as negative, the sensitivity was 96.7%, specificity 85.9%, positive predictive value 76.6%, negative predictive value 98.2%, and accuracy 89.4%. Ultrasonography features of malignancy were more prevalent in thyroid nodules that were malignant compared with those that were benign or considered likely to be benign (70.3% vs. 1.2%, p < 0.001), and ultrasonography features of a benign nodule were more prevalent in thyroid nodules that were benign or considered likely to be benign than those that were malignant (94.9% vs. 29.7%, p < 0.001).Conclusion: In this study, US-FNAB appeared to be a relatively accurate method to evaluate thyroid nodules larger than 3 cm, with false-negative rates of about 2%. Much larger series would be required to determine its utility in this setting.