CAJ | 학술논문

目的：探讨超声联合细针穿刺细胞病理学（FNA）在诊断甲状腺结节中的价值。方法：回顾性分析2010年2月至2014年7月甲状腺手术病例2491例，其中甲状腺癌249例，分析其甲状腺B超和FNA的特点，前者包括甲状腺体积的大小、结节的多少和大小、回声以及边缘情况、微钙化状况、纵横比失调情况，后者包括核沟和核内包涵体、玻璃样染色质和乳头状结构。分析甲状腺B超和FNA单独及联合诊断甲状腺癌的敏感性和特异性。结果：甲状腺B超提示恶性的单个指标分别是结节内微钙化、单个结节大于2 cm和纵横比失调，但是不能直接判定良恶性。FNA诊断甲状腺癌的敏感性和特异性分别为88%和77%。超声联合FNA的诊断敏感性和特异性为71%和96%。结论：在术前鉴别甲状腺结节的良恶性方面，B超联合FNA仍是一线的经济有效的检测方法。
목적：탐토초성연합세침천자세포병이학（FNA）재진단갑상선결절중적개치。방법：회고성분석2010년2월지2014년7월갑상선수술병례2491례，기중갑상선암249례，분석기갑상선B초화FNA적특점，전자포괄갑상선체적적대소、결절적다소화대소、회성이급변연정황、미개화상황、종횡비실조정황，후자포괄핵구화핵내포함체、파리양염색질화유두상결구。분석갑상선B초화FNA단독급연합진단갑상선암적민감성화특이성。결과：갑상선B초제시악성적단개지표분별시결절내미개화、단개결절대우2 cm화종횡비실조，단시불능직접판정량악성。FNA진단갑상선암적민감성화특이성분별위88%화77%。초성연합FNA적진단민감성화특이성위71%화96%。결론：재술전감별갑상선결절적량악성방면，B초연합FNA잉시일선적경제유효적검측방법。
Objective: To explore the application of ultrasonography combined with fine-needle aspira-tion (FNA) cytopathology on evaluating thyroid nodules.Methods: A total of 2 491 cases of thyroid surgery, of whom 249 cases were malignant from 2010 February to 2014 July were analyzed retrospectively, including the characteristics of ultrasonography and FNA cytopatholgoy. The former consisted of thyroid’s volume, number, size, hypoechogenecity, blur margin, microcalciifcation and taller-than-wide shape of thyroid nodule, the later in-cluded nuclear grooves, pseudoinclusions, ground glass and papillary architecture.Results: The single marker in thyroid ultrasonography related with malignancy was nodular microcalciifcation, single nodule larger than 2 cm and taller-than-wide nodule (allP<0.05), but all of which couldn’t tell the nature of thyroid nodules. The diagnos-tic sensitivity and speciifcity of FNA cytopathology on thyroid cancer was 88% and 77%, and the combination of ultrasonography and FNA cytopathology was 71% and 96%.Conclusion: In this regard of distinguishing the difference of benign and malignant nodule of thyroid, ultrasonography combined with FNA cytopathology is the ifrst line and cost-effective evaluation method.