CAJ | 학술논문

目的探讨超声引导下粗针组织活检(CNB)对甲状腺结节诊断临床上的应用价值.方法回顾性分析395例超声引导下甲状腺结节CNB的临床资料,对其中278例行外科手术者CNB及术后石蜡病理学结果进行比较.结果所有患者均穿刺成功.活检取材满意度为100％.1例出现穿刺后局部血肿,经保守治疗后缓解.共穿刺395例患者,其中278例患者行外科手术,术前CNB病理学结果显示:92例考虑为恶性,其中91例为甲状腺乳头状癌,1例为髓样癌；182例考虑为良性,其中其中1例为甲状旁腺腺瘤,48例为甲状腺腺瘤,133例为结节性甲状腺肿及其他非肿瘤性病变.其中273例穿刺病理学结果与术后石蜡病理学结果相符(90例恶性,183例良性),1例为假阳性,4例不确定病例.故超声引导下CNB对甲状腺结节良、恶性鉴别诊断的准确率、敏感性、特异性、漏诊率和误诊率分别为98.20％ (273/278)、95.79％(91/95)、99.45％(182/183)、4.21％ (4/95)和0.55％ (1/183).结论超声引导下CNB对甲状腺结节具有很高的鉴别诊断价值,是一种安全、有效的方法.
목적 탐토초성인도하조침조직활검(CNB)대갑상선결절진단림상상적응용개치.방법 회고성분석395례초성인도하갑상선결절CNB적림상자료,대기중278례행외과수술자CNB급술후석사병이학결과진행비교.결과 소유환자균천자성공.활검취재만의도위100％.1례출현천자후국부혈종,경보수치료후완해.공천자395례환자,기중278례환자행외과수술,술전CNB병이학결과현시:92례고필위악성,기중91례위갑상선유두상암,1례위수양암；182례고필위량성,기중기중1례위갑상방선선류,48례위갑상선선류,133례위결절성갑상선종급기타비종류성병변.기중273례천자병이학결과여술후석사병이학결과상부(90례악성,183례량성),1례위가양성,4례불학정병례.고초성인도하CNB대갑상선결절량、악성감별진단적준학솔、민감성、특이성、루진솔화오진솔분별위98.20％ (273/278)、95.79％(91/95)、99.45％(182/183)、4.21％ (4/95)화0.55％ (1/183).결론 초성인도하CNB대갑상선결절구유흔고적감별진단개치,시일충안전、유효적방법.
Objective To explore the value of ultrasound-guided core needle biopsy (CNB) in diagnosis of thyroid nodules.Methods The clinical data of 395 patients with thyroid nodules who underwent ultrasound-guided CNB were retrospectively analyzed,and the results of CNB pathology of 278 patients who endured surgery were compared with postoperative wax pathology results.Results All patients completed CNB successfully and satisfaction rate for tissue samples was 100％.Local hematoma occurred in one case and relieved by conservative therapy.The CNB pathology results of 278 cases of patients were as follows:92 cases were malignancy,including 91 cases of papillary thyroid carcinoma,lcase of medullary thyroid carcinoma; 182 cases were benign,including lcase of parathyroid adenoma,48 cases of adenoma,and 133 cases of nodular goitre and other nodular affection.In 278 patients who underwent surgery,the CNB pathology results in 273 cases,including 90 malignancy cases and 183 benign cases,were consistent with postoperative wax pathology results and false positive occurred in 1 cases,ambiguous occurred in 4 cases.So the accuracy,sensibility,specificity,missed diagnosis rate,and misdiagnosis rate of ultrasound-guided CNB for differential diagnosis of thyroid malignant nodules from benign nodules were 98.20％ (273/278),95.79％ (91/95),99.45％ (182/183),4.21％ (4/95) and 0.55％ (1/183).Conclusion Ultrasound-guided CNB has important value on differential diagnosis of thyroid nodules.It is safe and effective.