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细针穿刺细胞学在C-TIRADS4类甲状腺结节合并桥本甲状腺炎的诊断应用价值

Value of fine-needle aspiration cytology in the diagnosis of C-TIRADS4 thyroid nodules complicated with Hashimoto

投稿时间：2024-07-18 修订日期：2024-09-17

DOI：

中文关键词: 穿刺细胞学甲状腺结节桥本甲状腺炎诊断应用价值

英文关键词:puncture cytology thyroid nodules Hashimoto

基金项目:

作者	单位	邮编
王萍萍	日照市中心医院	276800
张永生^*	日照市中心医院	276800
张立平	日照市中心医院
高萍	日照市中心医院
崔久栋	日照市中心医院
张文振	日照市中心医院

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中文摘要:

[目的] 探讨超声引导下细针穿刺细胞学（FNAC）检查在C-TIRADS4类甲状腺结节合并桥本甲状腺炎（HT）的诊断应用价值。[方法] 选取2020年6月-2023年12月于日照市中心医院行FNAC的甲状腺结节1142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-TIRADS4类。比较HT（+）组与HT（-）组FNAC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（P=0.006）。 HT（+）组FNAC的灵敏度78.6%、准确度81.5%、特异度95.4%。HT（-）组FNAC的灵敏度87.2%、准确度88.4%、特异度98.1%。HT（+）组患者FNAC灵敏度和准确度低于HT（-）组，差异均具有统计学意义（P＜0.05）。[结论] FNAC是甲状腺结节诊断的有效手段，在C-TIRADS4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度。

英文摘要:

[Objective] To investigate the value of ultrasound-guided fine needle aspiration cytology (FNAC) in the diagnosis of C-TIRADS4 thyroid nodules complicated with Hashimoto"s thyroiditis (HT).[Methods] A total of 1142 thyroid nodules (579 with HT and 563 without HT) who underwent FNAC in Rizhao Central Hospital from June 2020 to December 2023 were selected. All patients underwent two-dimensional ultrasonography indicating C-TIRADS4 thyroid nodules. The diagnostic performance of FNAC was compared between the HT(+) group and the HT(-) group.[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 FNAC in the HT(+) group was significantly lower than that in the HT(-) group (P=0.006). The sensitivity, accuracy and specificity of FNAC in the HT(+) group were 78.6%, 81.5% and 95.4%. The sensitivity, accuracy and specificity of FNAC in the HT(-) group were 87.2%, 88.4% and 98.1%. The sensitivity and accuracy of FNAC in the HT(+) group were lower than those in the HT(-) group. The differences were statistically significant(P＜0.05).[Conclusion] FNAC is an effective method for the diagnosis of thyroid nodules, and has high specificity in C-TIRADS4 thyroid nodules. however, the presence of HT reduces the sensitivity and accuracy of diagnosis.

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