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中华普外科手术学杂志(电子版) ›› 2019, Vol. 13 ›› Issue (01) : 69 -72. doi: 10.3877/cma.j.issn.1674-3946.2019.01.022

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论著

甲状腺结节超声引导下粗针穿刺组织学活检的有效性研究
万文博1, 汪伟1, 夏长虹1,(), 罗渝昆1   
  1. 1. 100853 北京,解放军总医院超声诊断科
  • 收稿日期:2018-03-22 出版日期:2019-02-26
  • 通信作者: 夏长虹

An effectiveness study on the value of ultrasound guided core needle biopsy for the diagnosis of thyroid nodules

Wenbo Wan1, Wei Wang1, Changhong Xia1,(), Yukun Luo1   

  1. 1. Department of PLA General Hospital, Beijing 100853, China
  • Received:2018-03-22 Published:2019-02-26
  • Corresponding author: Changhong Xia
  • About author:
    Corresponding author: Xia Changhong, Email:
引用本文:

万文博, 汪伟, 夏长虹, 罗渝昆. 甲状腺结节超声引导下粗针穿刺组织学活检的有效性研究[J/OL]. 中华普外科手术学杂志(电子版), 2019, 13(01): 69-72.

Wenbo Wan, Wei Wang, Changhong Xia, Yukun Luo. An effectiveness study on the value of ultrasound guided core needle biopsy for the diagnosis of thyroid nodules[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(01): 69-72.

目的

研究甲状腺结节超声引导下粗针穿刺(US-CNB)组织学活检的有效性,探讨其对甲状腺结节的诊断价值。

方法

回顾性分析2009年6月至2016年6月行术前US-CNB的2 051例患者的2 286个结节的病理诊断,将其中在本院行手术切除的530个甲状腺结节纳入本研究。以术后组织病理学为金标准,采用SPSS 19.0统计软件分析处理数据,分析US-CNB病理诊断的敏感度、特异度、阳性预测值、阴性预测值、准确度,并用ROC曲线对比粗针穿刺活检病理结果及手术病理结果。

结果

US-CNB的2 286个甲状腺结节中仅2例取材不成功,2 284个(99.9%)结节取材切片成功,得到组织病理诊断;530个术后结节的US-CNB的诊断敏感度、特异度、阳性预测值、阴性预测值、准确度分别99.8%、86.5%、98.6%、97.8%和98.5%。

结论

由于US-CNB对甲状腺结节有很高的取材成功率及病理诊断准确率,从而对甲状腺结节有很高的术前诊断价值。

Objective

To evaluate the effectiveness of ultrasound guided core needle biopsy (CNB) for the diagnosis of thyroid nodules.

Methods

From June 2009 to June 2016, 2286 thyroid nodules from 2051 patients undergoing ultrasound guided CNB (US-CNB) in our department and 530 nodules undergoing surgical operation were included in this study. Final diagnosis was confirmed by surgical pathological results. The data were analyzed using SPSS19.0 software. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were calculated, and ROC curve was used to compare the CNB and the surgical pathological results.

Results

The biopsy samples were successfully obtained from 2284 nodules (2284/2286), and the inconclusive result occurred in 2 nodules (2/2286). The sensitivity, specificity, PPV, NPV and accuracy of US-CNB in the 530 nodules were 99.8%, 86.5%, 98.6%, 97.8%, and 98.5%, respectively.

Conclusion

US-CNB has high success rates and diagnostic accuracy; therefore, it is a useful tool for the preoperative diagnosis of thyroid nodules.

图2 穿刺针贯穿甲状腺结节内部
图4 穿刺的甲状腺组织固定包埋后制成切片
图5~6 显微镜下放大100倍显示甲状腺组织结构异型性
图7 显微镜下放大400倍显示甲状腺细胞核水平异型性
表1 530个甲状腺结节CNB病理诊断结果与术后病理结果对照表(个)
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