摘要:
Objective To study the application value of fine-needle aspiration (FNA) and Core-needle biopsy (CNB) in diagnosis of the benign and malignancy thyroid neoplasm. Methods We conducted a retrospective analysis between July 2015 and September 2017 on 279 patients with total of 296 lesions in our hospital. 141 patients had a total of 148 lesions which excepted 42 lesions of suspected malignancy and 5 lesions of dissatisfaction. Totally 101 lesions were examined by FNA for pathological examination. CNB and pathological examination carryed out in the rest of 138 patients with 148 lesions which excepted 41 lesions of suspected malignancy and 2 lesions of dissatisfaction (totally, 105 lesions). Results FNA prompted 55 lesions of malignant and 46 lesions of benign, a total of 101 lesions. Respectively, FNA diagnostic sensitivity, specificity and diagnostic accuracy were 83.02%, 87.50%, 85.15%. CNB prompted 67 lesions of malignant and 38 lesions of benign, a total of 105 lesions. Respectively, CNB disgnostic sensitivity, specificity and diagnostic accuracy were 93.84%, 85.00%, 90.48%. FNA diagnosis accuracy rate (86.84%) in diameter less than 1.0 centimeter nodules was higher than CNB accuracy (79.41%). The CNB (86.84%) diagnosis accuracy rate in diameter not less than 1.0 centimeter lesions were higher than FNA (84.13%). Conclusion FNA and CNB cannot replace each other in the diagnosis of thyroid nodules, the two should complement each other. The diagnostic accuracy of FNA for thyroid nodules with a diameter less than 1 cm is higher.%目的 探讨细针抽吸(fine-needle aspiration, FNA)和粗针穿刺活检(core-needle biopsy, CNB)两种技术在甲状腺肿物良恶性诊断中的应用价值.方法 回顾性分析2015年7月~2017年9月来我院就诊的患者279例共296个病灶, 其中141例患者共148个病灶, 除可疑恶性42个及取材不满意5个, 共101个病灶进行FNA获得涂片送病理检查, 余138例患者共148个病灶, 除可疑恶性41个及取材不满意2个, 共105个病灶进行粗针穿刺活检并送病理检查.结果 FNA提示恶性55个, 良性46个, 共101个病灶, FNA诊断的敏感性、特异性、诊断准确率分别为83.02%, 87.50%, 85.15%.CNB提示恶性67个, 良性38个, 共105个病灶, CNB诊断的敏感性、特异性、诊断准确率分别为93.84%, 85%, 90.48%.FNA对于小于1.0cm的结节的诊断准确率(86.84%)高于CNB准确率(79.41%).CNB对大于等于1.0cm的结节诊断准确率(95.77%)高于FNA(84.13%).结论 FNA与CNB在甲状腺结节的诊断中不能互相取代, 二者应相互补充, 对于直径小于1cm的甲状腺结节FNA诊断准确率更高.