背景:甲状腺结节是一个常见的临床挑战,很大一部分是癌变的。细针抽吸细胞学(FNAC)广泛用于诊断,但有局限性。超声已成为区分良性和恶性结节的有希望的工具。本研究旨在以术后组织病理学检查为金标准,比较超声检查(USG)和FNAC在诊断恶性甲状腺肿胀中的诊断准确性。
方法:在Rajendra医学科学研究所进行了长达1.5年的诊断准确性研究,兰契,印度。共纳入132例甲状腺肿胀患者。患者接受了USG和FNAC,99例患者随后接受了手术和组织病理学检查。进行统计分析以评估USG和FNAC的性能,包括灵敏度,特异性,准确度,阳性预测值(PPV),和阴性预测值(NPV)。
结果:该研究包括132名患者,以94名(71.21%)女性为主。大多数病人,即,132人中有76人(57.58%),年龄在30-50岁之间,平均年龄为41岁。社会经济地位显示120(90.9%)属于II级和III级。USG和FNAC的敏感度分别为77.4%和90.3%,特异性为94.1%和98.5%,准确率为88.9%和96.0%,分别。与USG相比,FNAC表现出卓越的诊断性能指标,PPV和NPV较高,表明其正确识别真阳性病例的能力更强。超声特征和FNAC表现与活检结果显著相关,重申其在诊断甲状腺结节中的效用。
结论:FNAC成为区分良性和恶性甲状腺结节的高度准确的诊断工具,表现优于USG。了解人口统计学和临床特征可以帮助及时诊断和管理甲状腺疾病。需要进一步的研究来增强诊断算法并在资源受限的环境中优化患者护理。
BACKGROUND: Thyroid nodules are a common clinical challenge, with a significant proportion being cancerous. Fine-needle aspiration cytology (FNAC) is widely used for diagnosis but has limitations. Ultrasound has emerged as a promising tool for distinguishing between benign and malignant nodules. This study aims to compare the diagnostic accuracy of ultrasonography (USG) and FNAC in diagnosing malignant thyroid swelling using postoperative histopathological examinations as the gold standard.
METHODS: A diagnostic accuracy study was conducted over 1.5 years at Rajendra Institute of Medical Sciences, Ranchi, India. A total of 132 patients with thyroid swellings were included. Patients underwent USG and FNAC, and 99 patients subsequently underwent surgery and histopathological examination. Statistical analysis was performed to evaluate the performance of USG and FNAC, including sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV).
RESULTS: The study encompassed 132 patients, predominantly 94 (71.21%) females. Most patients, i.e., 76 out of 132 (57.58%), were aged 30-50 years, with an average age of presentation at 41 years. Socioeconomic status revealed 120 (90.9%) belonging to Classes II and III. USG and FNAC exhibited sensitivities of 77.4% and 90.3%, specificities of 94.1% and 98.5%, and accuracies of 88.9% and 96.0%, respectively. FNAC demonstrated superior diagnostic performance metrics compared to USG, with higher PPV and NPV, indicating its stronger ability to correctly identify true-positive cases. Ultrasound features and FNAC findings showed significant associations with biopsy results, reaffirming their utility in diagnosing thyroid nodules.
CONCLUSIONS: FNAC emerged as a highly accurate diagnostic tool for distinguishing between benign and malignant thyroid nodules, outperforming USG. Understanding demographic and clinical characteristics can aid in the timely diagnosis and management of thyroid disorders. Further research is warranted to enhance diagnostic algorithms and optimize patient care in resource-constrained settings.