| Objective:To evaluate the factors affecting the satisfaction rate of spcimens obtained by ultrasound-guided fine needle biopsy(US-FNAB)of thyroid nodules and the diagnostic value of FNAB combined with thyroid imaging reporting and data system(TI-RADS)in assessing the malignant risk of thyroid nodules.Methods:1.The FNAB results of 1114 thyroid nodules in 960 patients from Nov.2017 to Feb2019 were analyzed.All specimens were classified as satisfied or unsatisfied.The aim of this study was to evaluate the effects of needle type,numbers of times of puncture and ultrasonography features of the nodules on the satisfaction rate of specimens obtained in FNAB.2.The clinical data of 490 patients with 598 thyroid nodules were retrospectively analyzed.All nodules underwent FNAB after a conventional US examination and were confirmed by histological examination.The sensitivity,specificity,coincidence rate,negative predictive value and positive predictive value of TI-RADS,FNAB and combined application were calculated.The receiver-operating characteristic(ROC)curve was plotted and area under the curve(AUC)was calculated.Z-test was utilized to compare the AUC of ROC.Results:1: Of the 1114 thyroid nodules,the results of FNAB showed that 1022 specimens were satisfied and 92 samples were unsatisfactory.The satisfaction rate of professional needles aspiration of thyroid nodules(91.4%?93.4%)were significantly higher than that of common needles(87.3%).There was no statistically significant difference in the specimen satisfaction rate of different needle passes(P >0.05).There was no statistically significant difference in the specimen satisfaction rate of nodules with different ultrasonography features(P>0.05).There were no statistically significant differences among the adequacy rates achieved with 22-,23-,and 25-gauge needles in thyroid nodules with different ultrasonography features.2:Of the 598 thyroid nodules,histopathological tests showed that 150 were benign nodules and 448 were malignant nodules.The sensitivity,specificity,coincidence rate,negative predictive value and positive predictive of FNAB in the diagnosis of thyroid nodules were 99.0%,46.7%,89.6%,91.4% and 89.4% respectively.Malignant rate was31.7% in TBSRTC categories?/? nodules,while 5.6% in TI-RADS 4a nodules and75% in TI-RADS 4b/4c/5 nodules of categories ?,?.Malignant rate was 7.8% in TBSRTC categories ? nodules,while 2.4% in TI-RADS 4a nodules and 50% in TI-RADS 4b/4c/5 nodules of categories ?.Malignant rate was 84.7% in TBSRTC categories ? nodules,while 58.2% in TI-RADS 4a nodules and 94.1% in TI-RADS4b/4c/5 nodules of categories ? Malignant rate was 95.3% in TBSRTC categories ?nodules,while 85.3% in TI-RADS 4a nodules and 97.2% in TI-RADS 4b/4c/5 nodules of categories ?.The sensitivity,specificity,coincidence rate,negative predictive value and positive predictive were 99.8%,82.3%,91.3%,97.0% and 95.8% in TBSRTC and TI-RADS combined group respectively.The AUC(0.904)of combined diagnosis of the two methods was significantly higher than that of FNAB and TI-RADS(0.810,0.769)alone,and the difference was statistically significant(P < 0.05).Conclusion:1:The satisfaction rates of professional needles aspiration of thyroid nodules were significantly higher than those of common needles.The number of times of punctures and the ultrasonography features of nodules and different-gauge professional needles had no significant influence on the satisfaction rates of fine needle puncture specimen of thyroid nodules.2 : The combined use of the FNAB and TI-RADS could make more timely diagnosis possible of thyroid cancer,and might be useful for arriving at an optimal treatment strategy after FNAB in thyroid nodules. |
PDF Full Text Request