Does Tumor Size Influence the Diagnostic Accuracy of Ultrasound-Guided Fine-Needle Aspiration Cytology for Thyroid Nodules?
Does Tumor Size Influence the Diagnostic Accuracy of Ultrasound-Guided Fine-Needle Aspiration Cytology for Thyroid Nodules?
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DOI：
10.1155/2016/3803647
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发表时间：
2016
影响因子：
2.8
通讯作者：
Youn YK
中科院分区：
文献类型：
--
作者：
Koo DH;Song K;Kwon H;Bae DS;Kim JH;Min HS;Lee KE;Youn YK
背景细针穿刺细胞学检查（FNAC）是甲状腺结节的诊断标准。然而，大小对FNAC准确性的影响仍不清楚，特别是在太小或太大的甲状腺结节。这项回顾性队列研究的目的是研究结节大小对FNAC准确性的影响。方法.入组了2010年因结节接受甲状腺切除术的所有连续患者。FNAC结果（根据Bethesda系统）与病理诊断进行比较。根据超声最大直径将结节分为A-E组（分别为≤0.5、>0.5-1、>1-2、>2-4和>4 cm）。结果502例690个结节。总体FNAC敏感性、特异性、阳性预测值、阴性预测值和准确性分别为95.4%、98.2%、99.4%、86.4%和96.0%。A-E组的假阴性率（FNR）分别为3.2%、5.1%、1.3%、13.3%和50%。A-E组的准确率分别为96.8%、94.8%、99%、94.7%和87.5%。结论虽然FNAC在小于0.5 cm的甲状腺结节中的准确率与其他组相当，但大于4 cm且细胞学检查为良性的甲状腺结节恶性风险较高，这表明应考虑加强随访或重复活检。
Background. Fine-needle aspiration cytology (FNAC) is diagnostic standard for thyroid nodules. However, the influence of size on FNAC accuracy remains unclear especially in too small or too large thyroid nodules. The objective of this retrospective cohort study was to investigate the effect of nodule size on FNAC accuracy. Methods. All consecutive patients who underwent thyroidectomy for nodules in 2010 were enrolled. FNAC results (according to the Bethesda system) were compared to pathological diagnosis. The nodules were categorized into groups A–E on the basis of maximal diameter on ultrasound (≤0.5, >0.5–1, >1-2, >2–4, and >4 cm, resp.). Results. There were 502 cases with 690 nodules. Overall FNAC sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.4%, 98.2%, 99.4%, 86.4%, and 96.0%, respectively. False-negative rates (FNRs) of groups A–E were 3.2%, 5.1%, 1.3%, 13.3%, and 50%, respectively. Accuracy rates of groups A–E were 96.8%, 94.8%, 99%, 94.7%, and 87.5%, respectively. Conclusion. Although accuracy rates of FNAC in thyroid nodules smaller than 0.5 cm are comparable to the other group, thyroid nodules larger than 4 cm with benign cytology carry a higher risk of malignancy, which suggest that those should be considered for intensive follow-up or repeated biopsy.
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影响因子：
3.7
作者：
Moon, Hee Jung;Son, Eunju;Kwak, Jin Young
通讯作者：
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影响因子：
5.8
作者：
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2.4
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影响因子：
3.5
作者：
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通讯作者：
Hanley, Krisztina Z.