Application of different puncture methods to cytological examination of thyroid nodule

doi:10.3877/cma.j.issn.1674-3946.2023.03.021

Abstract

Abstract:

Objective

To explore the application of different puncture methods for cytological examination of thyroid nodule in patients. Methods A total of 120 patients who received ultrasound-guided thyroid nodule cytology from April 2018 to June 2019 were retrospectively analyzed and divided into 2 groups according to different puncture methods. Group A received negative pressure fine needle puncture cytology（FNNAC），group B received continuous negative pressure fine needle puncture cytology（FNAC），SPSS 21.0 software was used for analysis，measurement data were expressed as（

x ˉ

±s），independent sample t test. All the data were tested by χ² test. Kappa test was used to compare the cytological diagnosis results between the two groups based on the diagnostic results of surgical pathology biopsy. P<0.05 was considered statistically significant.

Results

There were no significant differences in the average size of thyroid nodule，nodule blood flow，nodule number，calcification and internal composition between 2 groups（P>0.05）. Compared with the diagnostic results of postoperative pathological biopsy，there were no significant differences in positive predictive value，negative predictive value，sensitivity，specificity，Yoden index and diagnostic accuracy between the two groups of puncture methods（P>0.05）. The Kappa test values of cytological diagnosis results and pathological diagnosis results of puncture methods in group A and Group B were 0.630 and 0.621，and the diagnostic results of the two puncture methods were consistent with the pathological diagnosis results（P<0.05），and the consistency of the two methods with the pathological diagnosis results was similar（similar Kappa value）.

Conclusion

Fine needle puncture with or without negative pressure has similar effect in the diagnosis of thyroid nodule in patients，which is consistent with the pathological diagnosis results. Selective puncture and smear can be performed according to clinical needs.

Key words: Thyroid Nodule, No Negative Pressure, Continuous Negative Pressure, Cytological Examination, Comparative Effectiveness Research

Jixin Chai, Xue Zhang, Shizhi He, Yantao Qi, Jingjing Wang, Yazhou Ao, Yong Chen. Application of different puncture methods to cytological examination of thyroid nodule[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2023, 17(03): 315-318.

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Figures/Tables 6

References 15

[1]	杨增娣，杨艳婷，吕永燕，等. 不同甲状腺结节大小超声引导下细针穿刺细胞学诊断敏感性和准确性比较［J］. 河北医学，2022，28（01）：81-85.
[2]	Yoo WS，Ahn HY，Ahn HS，et al. Malignancy rate of Bethesda category III thyroid nodules according to ultrasound risk stratification system and cytological subtype［J］. Medicine（Baltimore），2020，99（2）：e18780.
[3]	Kang JY，Yi KS，Cha SH，et al. Schwannoma of the thyroid bed：A case report and review of the literature［J］. Medicine，2020，99（5）：e18814.
[4]	Mashiana S，Duarte EM. Metastatic Mucoepidermoid Carcinoma to the Pleura：An Unusual Presentation［J］. J Clinic Pathol，2020，154（Supplement_1）：S27-S28.
[5]	Galimzianova A，Siebert SM，Kamaya A，et al. Quantitative Framework for Risk Stratification of Thyroid Nodules With Ultrasound：A Step Toward Automated Triage of Thyroid Cancer［J］. AJR Am J Roentgenol，2020，214（4）：885-892.
[6]	中华医学会内分泌学分会，中华医学会外科学分会，中国抗癌协会头颈肿瘤专业委员会，等. 甲状腺结节和分化型甲状腺癌诊治指南［J］. 中国肿瘤临床，2012，39（17）：1249-1272.
[7]	Magri F，Chytiris S，Molteni M，et al. Laser photocoagulation therapy for thyroid nodules：long-term outcome and predictors of efficacy［J］. J Endocrinol Invest，2020，43（1）：95-100.
[8]	赵媛，赵永刚，张春芳，等. 超声、细针穿刺细胞学及BRAFV600E基因对甲状腺结节的诊断价值［J］. 实用医学杂志，2020，36（24）：3420-3424.
[9]	徐嘉，张子笠，王玉龙. 原发性甲状腺鳞状细胞癌二例报道［J/CD］. 中华普外科手术学杂志（电子版），2020，14（06）：647.
[10]	周斌，翟翼飞，张冬雁，等. 联合 BRAFV600E基因检测在甲状腺结节穿刺细胞学诊断为BethesdaⅢ类中的辅助诊断作用［J］. 中华耳鼻咽喉头颈外科杂志，2020，55（11）：1057-1062.
[11]	Kim M，Park HJ，Min HS，et al. The Use of the Bethesda System for Reporting Thyroid Cytopathology in Korea：A Nationwide Multicenter Survey by the Korean Society of Endocrine Pathologists［J］. J Pathol Transl Med，2017，51（4）：410-417.
[12]	Shimode Y，Tsuji H，Fukuhara T，et al. Examination of selective low-pressure fine needle aspiration cytology under ultrasound guidance［J］. Yonago Acta Med，2017，60（3）：209-212.
[13]	万文博，汪伟，夏长虹，等. 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/CD］. 中华普外科手术学杂志（电子版），2019，13（01）：69-72.
[14]	李锐，曹丁方，张雪，等. 细针穿刺细胞学与术中冷冻病理诊断对甲状腺结节手术的指导价值探讨［J］. 中国医刊，2022，57（07）：775-778.
[15]	Rossi D，Belotti A，Tonno C，et al. Changes in thyroid fine needle aspiration practice during the COVID‐19 pandemic［J］. Cytopathology，2021，32（6）：732-737.

组别	例	男/女	年龄(岁)	结节直径(mm)
A组	60	28/32	53.7±14.1	10.5±4.2
B组	60	25/35	54.2±13.9	10.2±4.2
t/χ²值		0.314	0.197	0.274
P值		0.588	0.873	0.392

组别	例	男/女	年龄(岁)	结节直径(mm)
A组	60	28/32	53.7±14.1	10.5±4.2
B组	60	25/35	54.2±13.9	10.2±4.2
t/χ²值		0.314	0.197	0.274
P值		0.588	0.873	0.392

细胞学检验项目	A组(n=60)	B组(n=60)	χ²/t值	P值
大小(mm)	10.5±4.2	10.2±4.2	0.274	0.392
血流(有/无)	36/24	40/20	0.574	0.449
数量(单发/多发)	16/44	18/42	0.164	0.685
钙化(有/无)	37/23	34/26	0.310	0.577
边缘情况(清晰/模糊)	19/41	22/38	0.333	0.564
回声			-	0.413
低回声	45	43
高回声	0	0
等回声	3	4
混合回声	12	13
内成分			-	0.689
实性	50	52
实性为主	10	8
囊性为主	0	0

细胞学检验项目	A组(n=60)	B组(n=60)	χ²/t值	P值
大小(mm)	10.5±4.2	10.2±4.2	0.274	0.392
血流(有/无)	36/24	40/20	0.574	0.449
数量(单发/多发)	16/44	18/42	0.164	0.685
钙化(有/无)	37/23	34/26	0.310	0.577
边缘情况(清晰/模糊)	19/41	22/38	0.333	0.564
回声			-	0.413
低回声	45	43
高回声	0	0
等回声	3	4
混合回声	12	13
内成分			-	0.689
实性	50	52
实性为主	10	8
囊性为主	0	0

组别	阳性预测值	阴性预测值	灵敏度	特异度	约登指数	准确率
A组	77.8	86.1	73.7	88.6	62.3	83.3
B组	84.2	81.1	69.7	90.9	60.6	82.1
χ²值	1.343	0.922	0.396	0.297	0.059	0.050
P值	0.247	0.337	0.529	0.586	0.808	0.824

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