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Received:October 28, 2019 Published Online:July 20, 2020
Received:October 28, 2019 Published Online:July 20, 2020
中文摘要: 目的 探讨超声引导下甲状腺细针穿刺(US-FNA)液基细胞学与传统细胞涂片在甲状腺结节诊断中的临床意义。
方法 选择2017年7月至2019年10月进行US-FNA检查的70例甲状腺结节患者作为研究对象,并以术后组织病理学诊断为金标准,分别分析液基细胞学病理、传统细胞涂片病理以及二者联合检测与手术病理组织学诊断的一致性,同时比较三种检测方式的诊断准确率、假阳性率。
结果 以术后病理组织学结果为金标准,分析各种方法对甲状腺结节良恶性的诊断效能:(1)液基细胞学与传统细胞涂片结果有一致性,但一致性差(Kappa值=0.205,P>0.05);(2)液基细胞学、传统细胞涂片以及二者联合方法,分别与术后病理组织学结果具有一致性(Kappa值=0.744、0.826、0.882,P均<0.01),且联合方法与术后病理组织学结果的一致性高于单一液基细胞学和传统细胞涂片;(3)联合方法的诊断准确率(97.56%)>单一传统细胞涂片(90.24%)>单一液基细胞学(80.49%);联合方法、单一传统细胞涂片和单一液基细胞学诊断的假阳性率分别为6.90%、6.90%和3.45%。
结论 US-FNA液基细胞学联合传统细胞涂片方法能够提高单一检测识别恶性甲状腺结节与病理组织学的一致性,有效提高诊断的准确率。
Abstract:Objective To investigate the clinical significance of liquid based cytology and conventional smear in ultrasound-guided fine needle aspiration(US-FNA) in the diagnosis of thyroid nodules.
Methods A total of 70 patients with thyroid nodules from July 2017 to October 2019 were selected as the subjects,and postoperative histopathological diagnosis was taken as gold standard.The consistency of pathological results of liquid based cytology,conventional smear and combined detection with surgical histopathological diagnosis was analyzed.At the same time,the positive rates and false positive rates of the three methods were compared.
Results According to the results of postoperative histopathology as the gold standard,the diagnostic efficacy of various methods in the diagnosis of malignant thyroid nodules was analyzed.(1)The results of liquid-based cytology were consistent with those of traditional cell smears,but the consistency was poor (κ=0.205,P>0.05).(2) The results of liquid-based cytology,traditional cell smear and the combination of the two methods were consistent with the results of postoperative histopathology,respectively(κ=0.744,0.826,0.882,all P<0.01),and the consistency between the combined method and postoperative histopathology was higher than that of single liquid-based cytology and traditional cell smear.(3) The diagnostic accuracy of combined method (97.56%)>single traditional cell smear (90.24%)>single liquid-based cytology (80.49%);the false positive rates of combined method,single traditional cell smear and single liquid-based cytology were 6.90%,6.90% and 3.45%,respectively.
Conclusion US-FNA liquid based cytology combined with conventional smear can effectively improve the consistency between single detection and histopathological identification of malignant thyroid nodules,and effectively improve the accuracy of diagnosis.
keywords: Thyroid nodule Fine needle aspiration,ultrasound-guided Liquid based cytology Conventional cell smear Histopathology Diagnostic efficacy
文章编号: 中图分类号: 文献标志码:B
基金项目:
Author Name | Affiliation |
WANG Qing-yin*,SUN Mao-sheng | *Department of Endocrinology,Fuyang Hospital of Anhui Medical Universiy,Fuyang,Anhui 236000,China |
孙茂盛2 | 2.安徽医科大学附属阜阳医院超声科,安徽 阜阳236000 |
Author Name | Affiliation |
WANG Qing-yin*,SUN Mao-sheng | *Department of Endocrinology,Fuyang Hospital of Anhui Medical Universiy,Fuyang,Anhui 236000,China |
孙茂盛2 | 2.安徽医科大学附属阜阳医院超声科,安徽 阜阳236000 |
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