| 王萍萍,张永生,张立平,等.细针穿刺细胞学在C-TIRADS 4类甲状腺结节合并桥本甲状腺炎中的诊断价值[J].肿瘤学杂志,2025,31(2):122-127. |
| 细针穿刺细胞学在C-TIRADS 4类甲状腺结节合并桥本甲状腺炎中的诊断价值 |
| Value of Fine-Needle Aspiration Cytology in the Diagnosis of C-TIRADS 4 Thyroid Nodules Complicated with Hashimoto’s Thyroiditis |
| 投稿时间：2024-07-18 |
| DOI：10.11735/j.issn.1671-170X.2025.02.B006 |
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| 中文关键词: 细针穿刺细胞学 甲状腺结节 桥本甲状腺炎 诊断 |
| 英文关键词:fine needle aspiration cytology thyroid nodules Hashimoto’s thyroiditis diagnosis |
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| 中文摘要: |
| 摘 要：［目的］ 探讨超声引导下细针穿刺细胞学（fine needle aspiration cytology，FNAC）检查在中国甲状腺影像报告和数据系统（Chinese-Thyroid Imaging Reporting and Data System，C-TIRADS） 4类甲状腺结节合并桥本甲状腺炎（Hashimoto’s thyroiditis，HT）中的诊断价值。［方法］ 选取2020年6月至2023年12月于日照市中心医院行FNAC的甲状腺结节病例1 142例（伴HT 579例，不伴HT 563例）。所有患者均行二维超声检查提示甲状腺结节C-TIRADS 4类。比较FNAC对HT（+）组和HT（-）组的诊断效能。［结果］ HT（+）组579例结节中，Bethesda Ⅱ类77例（13.3％），Ⅲ类162例（28.0％），Ⅳ类6例（1.0％），Ⅴ类130例（22.5％），Ⅵ类204例（35.2％）。HT（-）组563例结节中，Bethesda Ⅱ类82例（14.6％），Ⅲ类101例（17.9％），Ⅳ类11例（2.0％），Ⅴ类121例（21.5％），Ⅵ类248例（44.0％）。HT（+）组甲状腺结节FNAC阳性率显著低于HT（-）组（57.7% vs 65.5%，P=0.006）。 HT（+）组FNAC的灵敏度为78.6%，特异度为95.4%，准确率为81.5%；HT（-）组FNAC的灵敏度为87.2%，特异度为98.1%，准确率为88.4%；HT（+）组患者FNAC灵敏度和准确率低于HT（-）组，差异有统计学意义（P=0.001，P=0.002）。［结论］ FNAC是甲状腺结节诊断的有效手段，在C-TIRADS 4类甲状腺结节中特异度高，但合并HT降低了诊断的灵敏度和准确率。 |
| 英文摘要: |
| Abstract： ［Objective］ To investigate the value of ultrasound-guided fine needle aspiration cytology (FNAC) in the diagnosis of C-TIRADS 4 thyroid nodules complicated with Hashimoto’s thyroiditis(HT). ［Methods］ A total of 1 142 patients who underwent two-dimensional ultrasonography and FNAC in Rizhao Central Hospital from June 2020 to December 2023 and indicating C-TIRADS 4 thyroid nodules were enrolled in the study， including 579 cases with HT and 563 cases without HT. The diagnostic performance of FNAC was evaluated. ［Results］ Among the 579 nodules in the HT(+) group， there were 77 cases (13.3%) of Bethesda class Ⅱ， 162 cases (28.0%) of class Ⅲ， 6 cases (1.0%) of class Ⅳ， 130 cases (22.5%) of class Ⅴ， and 204 cases (35.2%) of class Ⅵ. Among the 563 nodules in the HT(-) group， there were 82 cases (14.6%) of class Ⅱ， 101 cases (17.9%) of class Ⅲ， 11 cases (2.0%) of class Ⅳ， 121 cases (21.5%) of class Ⅴ， and 248 cases (44.0%) of class Ⅵ. The positive rate of thyroid nodule for FNAC in the HT(+) group was significantly lower than that in the HT(-) group (57.7% vs 65.5%， P=0.006). The sensitivity， specificity and accuracy of FNAC in the HT(+) group were 78.6%， 95.4 and 81.5%， respectively. The sensitivity， specificity and accuracy of FNAC in the HT(-) group were 87.2%， 98.1% and 88.4% ， respectively. The sensitivity and accuracy of FNAC in the HT(+) group were lower than those in the HT(-) group (P=0.001，P=0.002). ［Conclusion］ FNAC is an effective method for the diagnosis of thyroid nodules， and has high specificity in C-TIRADS 4 thyroid nodules； however， the presence of HT reduces its sensitivity and accuracy of diagnosis. |
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