B超引导下甲状腺肿块细针穿刺细胞学诊断的临床病理分析

目的：比较B超引导下细针吸取穿刺和传统细针吸取穿刺在甲状腺肿块性质确定中意义。方法：使用B超引导下细针吸取穿刺（UG-FNAB）和传统细针吸取穿刺技术（C-FNAB）对225例甲状腺肿块进行穿刺活检，然后进行涂片，染色，镜检，结合临床作出细胞学诊断，并与组织切片诊断对照，比较两种方法的确诊率。结果：在UG—FNAB检测病例中59.3％的结节位于甲状腺右叶，40．7％肿块位于左叶和峡部。87％的患者甲状腺机能正常，结节最长径平均为2．8±1．1cm，部分病例符合甲状腺恶性肿瘤的超声影像学改变。在本研究中诊断为甲状腺乳头状癌的病例细胞学和组织学特点均符合甲状腺癌形态学特点。在225例研究病例中，总确诊率为72．89％（164／225），其中UG-FNAB组确诊率为90．58％（77／85），C-FNAB组确诊率为62．14％（87／140），两组确诊率比较有显著性差异（P〈0．05）。结论：本组研究数据显示比较C—FNAB，UG—FNAB在诊断甲状腺复杂性结节中具有更高的确诊率，特别是在C—FNAB方法不能得出明确诊断时。

Clinicopathological Analysis on Application of Ultrasonic Guidance Fine-needle Aspiration Biopsy Cytological Diagnosis to Thyroid Nodule

Objective： To compare the significance of conventional fine-needle aspiration biopsy and ultrasonic Guidance fine- needle aspiration biopsy in diagnosis of hyroid nodule. Methods： Diagnosis of 225 thyroid nodule were conducted by conventional fine- needle aspiration biopsy and ultrasonic Guidance fine-needle aspiration biopsy, and successively Aspiration, smear, stain, microscope observation then cytological diagnosis; compared to histological diagnosis, and Diagnosis rate were compared. Results： In all cases, 59.3% nodules located in right lobe of thyroid, 40.7% in left lobe and isthmus; 87% patients have normal thyroid function, average longest diameter was 2.8＋ 1.1 cm. Part of cases have ultrasonic diagnostic change of thyroid malignancy. In this study, diagnosed malignancy had the cytological and histological features of thyroid carcinoma. In all of 225 cases, total diagnostic rate was 72.89%, diagnostic rate of UG-FNAB group was 90.58% （77/85）and C-FNAB group was 62.14%（87/140）, there was significant difference between two group. Conclusions： Compared to C-FNAB, diagnosis rate for complex thyroid nodule by UG-FNAB was signicicantly higher than C-FNAB, especially non-diagnostic by C-FNAB.