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目的评估甲状腺结节大小对超声引导细针抽吸细胞学检查(US-FNAB)有效率的影响。方法回顾性分析四川大学华西医院超声科2011年3月至2014年4月期间两位医生行US-FNAB的甲状腺结节共1 142个(医生1和医生2各571个)的资料,根据Bethesda分类标准将细胞学结果分为穿刺有效和穿刺无效两类。根据结节最大径大小分为≤5 mm组、5~10 mm组、10~20 mm组、20~30 mm组及>30 mm组5组,统计两位医师总的和各自的穿刺有效率,并依据结节组别和穿刺有效率绘制曲线,分别对5组间和两位医师之间的穿刺有效率进行比较。结果医生1及医生2各自的和两位医师总的穿刺有效率≤5 mm组、5~10 mm组、10~20 mm组、20~30 mm组及>30 mm组分别为68.42%、83.72%、86.08%、84.62%和73.53%;68.75%、70.53%、81.05%、86.15%和73.91%;以及68.59%、77.53%、83.59%、85.47%和73.75%。两位医生总的穿刺有效率组间两两比较,≤5 mm组低于10~20 mm组(P<0.001)和20~30 mm组(P=0.001);医生1和医生2两位医生间5组中穿刺有效率比较仅5~10 mm组的差异有统计学意义(P=0.001)。结论甲状腺结节大小是影响US-FNAB穿刺有效率的重要因素,最大径≤5 mm和最大径>30 mm的结节穿刺有效率低,较大结节穿刺有效率低的原因与病变明显的囊性变有关。
Objective To evaluate the effect of thyroid nodule size on the efficiency of ultrasonography guided fine needle aspiration cytology (US-FNAB). Methods The data of 1 142 thyroid nodules (571 doctors and 1 doctor) by US-FNAB and US-FNAB from March 2011 to April 2014 were analyzed retrospectively according to the data of Bethesda The classification criteria will be divided into two types of cytology results puncture effective and puncture invalid. According to the maximum size of nodules, the patients were divided into 5 groups of ≤5 mm, 5 ~ 10 mm, 10 ~ 20 mm, 20 ~ 30 mm and> 30 mm. The total and their puncture efficacies , And according to the nodule grouping and puncture efficiency curve, the puncture efficiency between the 5 groups and two doctors were compared. Results The total effective rates of puncture of 5 doctors, 1 doctor doctor 2 and 2 physicians were 68.42% in the groups of 5 to 10 mm, 10 to 20 mm, 20 to 30 mm and 83 mm %, 86.08%, 84.62% and 73.53%; 68.75%, 70.53%, 81.05%, 86.15% and 73.91%, and 68.59%, 77.53%, 83.59%, 85.47% and 73.75% respectively. The total effective rate of puncture between the two doctors was no significant difference between any two groups, less than 5 mm in the group of less than 10-20 mm (P <0.001) and 20-30 mm (P = 0.001) The difference between the 5 groups in puncture efficiency was only 5 ~ 10 mm (P = 0.001). Conclusions The size of thyroid nodules is an important factor affecting the efficiency of US-FNAB puncture. The maximum effective diameter is less than 5mm and the maximum diameter is more than 30mm. The effective rate of nodules is low. Cystic change related.