论著

10 388个甲状腺结节行超声引导下细针抽吸活检的甲状腺癌各亚型诊断准确率的10年研究

展开
  • 上海交通大学医学院附属瑞金医院超声科,上海 200025

收稿日期: 2020-07-01

  网络出版日期: 2022-07-15

基金资助

国家自然科学基金(81671688)

Diagnostic accuracy of ultrasound-guided fine needle aspiration biopsy for different thyroid carcinoma in 10 388 thyroid nodules: a ten-year study

Expand
  • Department of Ultrasound, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2020-07-01

  Online published: 2022-07-15

摘要

目的: 探讨超声引导下细针抽吸活检(ultrasound-guided fine needle aspiration biospy,US-FNAB)对甲状腺恶性病变中亚型的诊断准确率。方法: 回顾性分析2010年1月至2019年12月间9 933例在上海交通大学医学院附属瑞金医院接受US-FNAB 者的相关资料,共10 388个甲状腺结节,以术后病理为金标准,评价US-FNAB诊断甲状腺癌的灵敏度、特异度、准确率、阳性预测值、阴性预测值等,并进一步分析其在恶性病变中各亚型的诊断准确率。结果: 总结10年间的US-FNAB结果数据发现,10 388个结节中有9 379个(90.3%)为恶性,总诊断灵敏度为95.4%,总特异度为84.7%,总阳性预测值98.4%,总阴性预测值为65.9%,总诊断准确率达94.4%;对于各恶性病变亚型,乳头状癌的诊断准确率为95.8%,髓样癌的诊断准确率为69.4%。结论: US-FNAB在恶性甲状腺结节诊断中具有较高的价值,其对甲状腺乳头状癌的诊断效能最高。

本文引用格式

王星, 汪蓉晖, 张桂萍, 董屹婕, 周伟, 詹维伟 . 10 388个甲状腺结节行超声引导下细针抽吸活检的甲状腺癌各亚型诊断准确率的10年研究[J]. 诊断学理论与实践, 2020 , 19(04) : 359 -363 . DOI: 10.16150/j.1671-2870.2020.04.007

Abstract

Objective: To investigate the diagnostic accuracy of ultrasound-guided fine needle aspiration biopsy (US-FNAB) in different subtypes of thyroid carcinoma. Methods: A total of 10 388 thyroid nodules from 9 933 patients undergone US-FNAB in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2010 to December 2019 were enrolled, and related data were retrospectively analyzed. The sensitivity, specificity, accuracy, positive and negative predictive value of US-FNAB for thyroid carcinoma were assessed by comparing to the results of surgical pathology. The accuracy rate of diagnosis between different subtypes of thyroid carcinoma was further analyzed. Results: The ten-year study revealed that among 10 388 nodules, 9 379 nodules were malignant. The total sensitivity, specificity, positive and negative predictive value of US-FNAB for thyroid carcinoma were 95.4%, 84.7%, 98.4%, 65.9% and 94.4%, respectively. For the subtypes of thyroid carcinoma, diagnostic accuracies for papillary carcinoma and medullary carcinoma were 95.8% and 69.4%, respectively. Conclusions: US-FNAB is valuable in the diagnosis of thyroid nodules and has the highest diagnostic accuracy for thyroid papillary carcinoma.

参考文献

[1] Hughes DT, Haymart MR, Miller BS, et al. The most commonly occurring papillary thyroid cancer in the Uni-ted States is now a microcarcinoma in a patient older than 45 years[J]. Thyroid, 2011, 21(3):231-236.
[2] Kowalska A, Walczyk A, Kowalik A, et al. Increase in papillary thyroid cancer incidence is accompanied by changes in the frequency of the BRAF V600E mutation: a single-institution study[J]. Thyroid, 2016, 26(4):543-551.
[3] Morris LG, Tuttle RM, Davies L. Changing trends in the incidence of thyroid cancer in the United States[J]. JAMA Otolaryngol Head Neck Surg, 2016, 142(7):709-711.
[4] Han L, Wu Z, Li W, et al. The real world and thinking of thyroid cancer in China[J]. IJS Oncology, 2019, 4(7):e81.
[5] Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2):115-132.
[6] Haugen BR, Alexander EK, Bible KC, et al. 2015 Ame-rican Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer[J]. Thyroid, 2016, 26(1):1-133.
[7] Danese D, Sciacchitano S, Farsetti A, et al. Diagnostic accuracy of conventional versus sonography-guided fine-needle aspiration biopsy of thyroid nodules[J]. Thyroid, 1998, 8(1):15-21.
[8] American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, et al. Revised American Thyroid Association Management Guidelines for Patients with Thyroid Nodules and Differentiated Thyroid Cancer[J]. Thyroid, 2009, 19(11):1167-1214.
[9] Ali SZ, Cibas ES. The Bethesda system for reporting thyroid cytopathology Ⅱ[J]. Acta Cytol, 2016, 60(5):397-398.
[10] 彭丽, 顾明君. Meta分析比较常规和超声引导下甲状腺细针穿刺细胞学检查对甲状腺结节的诊断价值[J]. 第二军医大学学报, 2007, 28(9):968-972.
[11] Shin JH, Baek JH, Chung J, et al. Ultrasonography diagnosis and imaging-based management of thyroid nodules: revised Korean Society of Thyroid Radiology Consensus Statement and Recommendations[J]. Korean J Radiol, 2016, 17(3):370-395.
[12] Tessler FN, Middleton WD, Grant EG, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee[J]. J Am Coll Radiol, 2017, 14(5):587-595.
[13] Wémeau JL, Sadoul JL, d'Herbomez M, et al. Guidelines of the French Society of Endocrinology for the Management of Thyroid Nodules[J]. Ann Endocrinol (Paris), 2011, 72(4):251-281.
[14] Baskin HJ, Duick DS. The endocrinologists' view of ultrasound guidelines for fine needle aspiration[J]. Thyroid, 2006, 16(3):207-208.
[15] Gharib H, Papini E, Garber JR, et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules- -2016 Update[J]. Endocr Pract, 2016, 22(5):622-639.
[16] Ke J, Jianyong L, Ying L, et al. The use of The Bethesda System for Reporting Thyroid Cytopathology in a Chinese population: an analysis of 13 351 specimens[J]. Diagn Cytopathol, 2019, 47(9):876-880.
[17] Zhu Y, Song Y, Xu G, et al. Causes of misdiagnoses by thyroid fine-needle aspiration cytology (FNAC): our experience and a systematic review[J]. Diagn Pathol, 2020, 15(1):1.
[18] Zhu Y, Song Y, Xu G, et al. The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC): a report of 2,781 cases in a Chinese population[J]. Chin J Cancer Res, 2020, 32(2):140-148.
[19] Furlan JC, Bedard YC, Rosen IB. Role of fine-needle aspiration biopsy and frozen section in the management of papillary thyroid carcinoma subtypes[J]. World J Surg, 2004, 28(9):880-885.
[20] DeLellis RA. Pathology and genetics of tumours of endocrine organs[M]. Lyon: IARC Press, 2004.
[21] Ali SZ, Cibas ES, SpringerLink(Online service). The Bethesda system for reporting thyroid cytopathology definitions, criteria and explanatory notes[M]. Boston, MA: Springer Science+Business Media, LLC, 2010.
[22] Trimboli P, Treglia G, Guidobaldi L, et al. Detection rate of FNA cytology in medullary thyroid carcinoma: A meta-analysis[J]. Clin Endocrinol (Oxf), 2015, 82(2):280-285.
[23] Ghofrani M, Ocal IT. Medullary thyroid carcinoma: a brief review of pathogenesis, diagnosis, and treatment[J]. Pathology Case Reviews, 2015, 20:204-209.
[24] Trimboli P, Cremonini N, Ceriani L, et al. Calcitonin measurement in aspiration needle washout fluids has higher sensitivity than cytology in detecting medullary thyroid cancer: a retrospective multicentre study[J]. Clin Endocrinol(Oxf), 2014, 80(1):135-140.
[25] Mathur A, Olson MT, Zeiger MA. Follicular lesions of the thyroid[J]. Surg Clin North Am, 2014, 94(3):499-513.
文章导航

/