Objective To retrospectively analyze and compare the clinical application value of core-needle biopsy (CNB) histology and fine needle aspiration (FNA) cytology in diagnosing malignant thyroid nodules. Methods A total of 134 patients with 137 thyroid nodules (93 malignant nodules and 44 benign nodules) were included in this study. Under ultrasound guidance, successive use of 22 G fine needle and18 G core-needle to puncture each nodule was performed for sampling of thyroid nodule. Surgical findings and pathological manifestations were compared with clinical follow-up results. The success rate of sampling and the diagnostic accuracy, sensitivity as well as specificity for malignant thyroid nodules were compared among FNA, CNB, and CNB/FNA. Results The success rate of puncture sampling with FNA, CNB and FNA/CNB for thyroid nodules was 89.1％, 97.8％ and 100％ respectively. For malignant thyroid nodules, the diagnostic accuracy of FNA, CNB and FNA/CNB was 79.6％, 91.9％ and 96.4％ respectively, the sensitivity was 81.7％, 94.6％ and 97.8％ respectively, and the specificity was 75.0％, 86.4％ and 93.2％ respectively. The success rate of puncture sampling by using CNB or FNA/CNB was significantly higher than that by using FNA (P<0.01), moreover, the diagnostic accuracy and sensitivity for malignant thyroid nodules by using CNB or FNA/CNB was also remarkably higher than those by using FNA (P<0.01) . Conclusion In making diagnosis of malignant thyroid nodules, CNB is accurate, safe and reliable. CNB can be used as a complementary or alternative technique to FNA in clinical practice.%目的 回顾性分析比较超声引导下粗针活检组织学 (CNB) 及细针穿刺细胞学 (FNA) 诊断甲状腺恶性结节的临床应用价值.方法 选取甲状腺结节患者134例共137个结节 (恶性93例, 良性44例), 超声引导下每个结节先后运用22 G细针及18 G粗针穿刺取材, 与手术病理及临床随访结果对照分析, 比较FNA、CNB及CNB/FNA取材成功率及诊断甲状腺恶性结节的准确性、灵敏度及特异度.结果本组病例FNA, CNB和FNA/CNB穿刺取材成功率分别为89.1％、97.8％及100％, 诊断甲状腺恶性结节准确性分别为79.6％、91.9％及96.4％, 灵敏度分别为81.7％、94.6％及97.8％, 特异度分别为75.0％、86.4％及93.2％.CNB及FNA/CNB的取材成功率明显高于FNA (P<0.01), 诊断甲状腺恶性结节的准确性及灵敏度均明显高于FNA (P<0.01) .结论 CNB诊断甲状腺恶性结节准确、安全可靠, 可以作为FNA的补充或者替代技术在临床推广应用.
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