22G 和25G 细针对超声引导下甲状腺富血供结节穿刺标本满意率的比较
1 南京医科大学附属南京医院超声医学科，南京市第一医院，南京 210006
|| 留学人员科技活动项目择优资助 [ 人社厅函 (2016)176 号 ]；南京市科技发展计划 (201803009)；南京市医学科技发展项目 (YKK15089)。
目的：比较22G和25G型号细针对甲状腺结节穿刺标本的满意率。方法：纳入2017年1月至 2018年1月至南京市第一医院进行甲状腺结节细针穿刺的166例患者(166个结节)，所有结节均用22G和25G针进行超声引导下细针穿刺抽吸细胞学检查(ultrasound-guided fine needle aspiration cytology， US-FNAC)。将甲状腺结节内部血流根据Adler分级法分为乏血供组(Adler 0~2级)与富血供组(Adler 3级)。所有标本进行细胞病理学涂片及液基薄层细胞学制片技术(thin-preparation cytologic test，TCT)检查，将标本分为满意和不满意2种。22G和25G针穿刺的先后顺序按照随机表进行，比较2种细针在进行甲状腺结节穿刺时标本的满意率。结果：22G针穿刺甲状腺结节的标本满意率83.1%(138/166)， 25G针穿刺甲状腺结节的标本满意率89.8%(149/166)，差异无统计学意义(P=0.07)。乏血供组结节的22G及25G针穿刺标本满意率差异无统计学意义(80.4% vs 82.1%，P=0.81)，富血供组结节25G标本满意率显著高于22G，差异有统计学意义(84.5% vs 93.6%，P=0.03)。结论：25G针取的细胞结构可以满足甲状腺结节细针穿刺细胞学病理诊断的标准，富血供结节使用25G针时标本满意率更高。
Comparison of 22G and 25G needles for determining sample satisfaction rate in the aspiration cytology of hypervascular thyroid nodules
This work was supported by the Scientific and Technological Programs for Outstanding Students by Chinese Students Abroad (No. 176), Nanjing Science and Technology Development Plan (201803009)
Objective: To compare the sample satisfaction rate of 22G and 25G needles used in the ultrasound-guided fine needle aspiration cytology (US-FNAC) of thyroid nodules. Methods: A total of 166 patients, 166 thyroid nodules from January 2017 to January 2018 in our hospital were included in this study, each nodule was aspirated with both 22G and 25G needles guided by ultrasound. According to the Adler stratifications of vascularity, 166 thyroid nodules were divided into a non-hypervascular group (Adler level 0–2) and a hypervascular group (Adler level 3). All specimens were directly smeared on glass slides and subjected to Thinprep Cytologic Test. Samples were divided into satisfied or unsatisfied. The order of 22G and 25G needle was in terms of random table, then the satisfaction rate between 22G and 25G was compared. Results: The satisfaction rate of 22G needle aspiration of thyroid nodules was 83.1% (138/166), while the satisfaction rate of 25G needle aspiration of thyroid nodules was 89.8% (149/166). There was no statistically significant difference between 22G and 25G needles in terms of the sample satisfaction rate (P=0.07). There was no statistically significant difference in a non-hypervascular group either (80.4% vs 82.1%, P=0.81). However, the sample satisfaction rate of a hypervascular group showed significant difference (84.5% vs 93.6%, P=0.03). Conclusion: 25G needles can aspirate adequate material for cytopathological diagnosis, it may have a higher satisfaction rate in nodules with rich blood supply.
thyroid nodules; fine needle aspiration cytology biopsy; ultrasound-guided