背景:本研究的目的是比较超声引导细针穿刺(FNA)和粗针活检(CNB)对甲状腺结节患者的诊断表现,在敏感性方面,特异性,准确度,阳性预测值(PPV)和阴性预测值(NPV)。
方法:本研究回顾性招募了2019年7月至2022年6月的47例中国患者。根据2017年Bethesda甲状腺细胞病理学报告系统(BSRTC),细胞学诊断分为六类。和组织学标本通过与Bethesda系统的类比进行诊断。
结果:所有合并的患者均进行了手术切除(SE),并接受了最终的手术诊断。两种方法的恶性率(ROM)相当,除了FNA组的检测阴性类别显着高于CNB组(39.25%vs.23.86%,p=.022)。CNB组的灵敏度和准确度均较高(82.50%和87.83%,分别)比FNA组(72.00%和79.36%,分别),以及净现值(76.14%的CNB与60.75%的FNA),但在特异性和PPV方面并非如此(FNA中的95.59%和97.30%与在CNB中为97.10%和98.02%)。
结论:CNB在甲状腺恶性病变中的敏感性和准确性高于FNA。FNA和CNB都表现出优异的性能,同时理解两者都需要在最合适的条件下应用以最大化其益处。
BACKGROUND: The object of this study was to compare the diagnosis performance of US-guided fine-needle aspiration (FNA) and core-needle biopsy (CNB) for patients with thyroid nodules, in aspects of sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV).
METHODS: Four hundred seven Chinese patients from July 2019 to June 2022 were retrospectively recruited in this study. Cytological diagnoses were categorized into six categories based on the 2017 Bethesda System for Reporting Thyroid Cytopathology (BSRTC), and histological specimens were drawn a diagnosis by means of an analogy with the Bethesda system.
RESULTS: All patients incorporated were proceed with surgical excision (SE) and received final surgical diagnoses. The rate of malignancy (ROM) was comparable between two methods, with the exception that the test-negative category of the FNA group was significantly higher than that of the CNB group (39.25% vs. 23.86%, p = .022). Sensitivity and accuracy were higher in CNB group (82.50% and 87.83%, respectively) than that in FNA group (72.00% and 79.36%, respectively), as well as NPV (76.14% in CNB vs. 60.75% in FNA), but not in terms of the specificity and PPV (95.59% and 97.30% in FNA vs. 97.10% and 98.02% in CNB).
CONCLUSIONS: CNB displayed a higher sensitivity and accuracy than FNA in malignant lesions of thyroid. Both FNA and CNB exhibit excellent performance with the understanding that both need to be applied under the most appropriate conditions to maximize their benefits.