甲状腺结节的彩色多普勒血流Adler 分级对超声引导下细针穿刺细胞学结果的影响
| 作者: |
1夏丛燕,
2卢延嘉,
1韩煜东,
1黄岩
1 南京医科大学附属南京医院，南京市第一医院超声医学科，南京 210006 2 东南大学附属中大医院超声医学科，南京 210009 |
| 通讯: |
黄岩
Email: jacob6666@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2018.10.008 |
| 基金: | 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)。 |
摘要
目的：探讨甲状腺结节的彩色多普勒血流Adler分级对超声引导下细针穿刺细胞学(ultrasound-guided f ine-needle aspiration c y tolog y，US -FNAC)结果的影响。方法：回顾性分析2014年6月至2017年 10月在南京市第一医院行US -FNAC并接受手术治疗的310个甲状腺结节，根据其甲状腺结节彩色多普勒血流Ad ler分级，将310例甲状腺结节分为A组 (0级，无血供) 、B组 (1级，低血供) 、 C 组 (2级，中等血供) 、 D 组 (3级，丰富血供)，以甲状腺结节石蜡切片病理结果为金标准，根据Bethesda System分类标准将US -FNAC的穿刺细胞病理结果与石蜡切片病理结果进行比较，分为符合和不符合两类。结果：310例甲状腺结节中，US -FNAC的细胞病理结果与石蜡切片的病理结果总体样本符合率为91.61%(284/310)， 4组的穿刺符合率分别为92.86%(65/70)， 95.12%(117/123)， 93.42%(71/76)， 75.61%(31/41)。 4 组间进行比较，差异具有统计学意义( P=0.001)，组间两两比较，D 组分别与 A组、B组、C组之间差异有统计学意义(P=0.019，0.001，0.009)，A组与B组、A组与C组、B组与 C组之间差异无统计学意义(P=0.532，P>0.999，P=0.751)。结论：甲状腺结节的彩色多普勒血流Adler分级，尤其是Adler 3级的甲状腺结节对US -FNAC穿刺效能有重要影响，Adler 0~2级对US-FNAC影响较小，血供丰富的Adler 3级会明显降低US-FNAC的穿刺符合率。
关键词：
甲状腺结节；细针穿刺抽吸；病理学
Effect of color Doppler flow Adler grading of thyroid nodules on the cytological results of fine needle aspiration guided by ultrasound
CorrespondingAuthor: HUANG Yan Email: jacob6666@163.com
DOI: 10.3978/j.issn.2095-6959.2018.10.008
Foundation: This work was supported by the Funding Scheme to Outstanding Scientific and Technological Programs by Chinese Students Abroad (2016-176), Nanjing Science and Technology Development Plan (201803009)
Abstract
Objective: To investigate the effect on vascularity stratification of thyroid nodules on the results of ultrasound-guided fine needle aspiration cytology (US-FNAC). Methods: The data of 310 thyroid nodules between June 2014 and October 2017 in Nanjing First Hospital were retrospectively analyzed. According to the Adler stratifications of vascularity, 310 thyroid nodules were divided into group A (level 0, nonvascular), group B (level 1, hypovascular), group C (level 2, isovascular) and group D (level 3, hypervascular). Results of US-FNAC were divided into two levels of accuracy and inaccuracy according to the paraffin pathological. Results: The accuracy of total of 310 nodules was 91.94%; the accuracy of A, B, C, and D groups were 94.29%, 95.12%, 93.42%, 75.61%, respectively. The accuracy of the four groups showed significant difference (P=0.001). Among the accuracy of four groups, group D and group A, group D and group B, group D and group C showed significant difference (P=0.019, 0.001, 0.009), group A and group B, group A and group C, group B and group C did not show significant difference (P=0.532, P>0.999, P=0.751). Conclusion: The vascularity stratification of thyroid nodules, especially vascularity with Adler 3 significantly influenced the efficacy of FNAC. Adler 0–2 had less influence on efficacy of FNAC than Adler 3, while the accuracy of those nodules with hypervascular like Adler 3 had been lowered in FNAC.
Keywords：
thyroid nodule; fine needle aspiration cytology; pathology