Ultrasound-guided fine-needle aspiration biopsy of thyroid masses
Ultrasound-guided fine-needle aspiration biopsy of thyroid masses
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DOI：
10.1089/thy.1998.8.283
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发表时间：
1998-04-01
期刊：
影响因子：
6.6
通讯作者：
Weigel, RJ
中科院分区：
文献类型：
--
作者：
Carmeci, C;Jeffrey, RB;Weigel, RJ
本研究的目的是确定超声引导下细针穿刺活检（USFNA）在结节性甲状腺疾病细胞学诊断中的作用。目前尚不清楚USFNA在结节性甲状腺疾病的细胞学诊断中应发挥何种作用。所有1991年至1996年在斯坦福大学医学中心接受细针穿刺（FNA）治疗结节性甲状腺疾病的患者均纳入本研究。对于那些接受手术的患者，将组织学诊断与细胞学诊断进行比较。共对497个甲状腺结节进行了FNA。对370个结节进行了触诊引导FNA（pFNA），对127个结节进行了USFNA。USFNA的原因如下：95例（75%）为不可触及或难以触及的结节; 14例（11%）为既往FNA失败; 18例（14%）为偶然发现的结节。FNA活检失败率为16%，敏感性和特异性分别为89%和69%。USFNA的活检失败率为7%，敏感性和特异性分别为100%和100%。pFNA手术时的癌症发生率为40%，USFNA手术时的癌症发生率为59%。USFNA与pFNA的互补使用改善了结节性甲状腺疾病的诊断方法。USFNA的使用增加了手术中的癌症发生率和我们机构甲状腺活检的敏感性。
The purpose of this study was to determine the impact of ultrasound-guided fine-needle aspiration biopsy (USFNA) in the cytological diagnosis of nodular thyroid disease. It remains unclear exactly what role USFNA should play in the cytological diagnosis of nodular thyroid disease. All patients who underwent fine-needle aspiration (FNA) for nodular thyroid disease at Stanford University Medical Center from 1991 to 1996 were included in the study. Histopathologic diagnoses were compared to cytological diagnoses for those patients who underwent surgery. FNA was performed on a total of 497 thyroid nodules. Palpation-guided FNA (pFNA) was performed on 370 nodules, and USFNA was done on 127. The, USFNAs were performed for the following reasons: 95 (75%) for nonpalpable or difficult-to-palpate nodules; 14 (11%) for previously failed FNA; and 18 (14%) for incidentally detected nodules. FNA had an unsuccessful biopsy rate of 16% and a sensitivity and specificity of 89% and 69%, respectively. USFNA had an unsuccessful biopsy rate of 7% and a sensitivity and specificity of 100% and 100%, respectively. The cancer yield at surgery for pFNA was 40%, and the cancer yield at surgery for USFNA was 59%. The complementary use of USFNA with pFNA improves the diagnostic approach to nodular thyroid disease. The use of USFNA has increased the cancer yield at surgery and the sensitivity of thyroid biopsy at our institution.