Significance of UltrasoundGuided Core Needle Biopsy in Diagnosis of Thyroid Nodules_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Guang , BIAN Xuehai , ZHANG Chunhai , FU Yantao , ZHAO Tao , SUN Hui

Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China;

Corresponding author：

Keywords：

Thyroid nodules; Core needle biopsy; Ultrasound-guided; Diagnosis; Treatment

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ObjectiveTo explore the value of ultrasound-guided core needle biopsy (CNB) in diagnosis of thyroid nodules. MethodsThe clinical data of 347 patients with thyroid nodules who underwent ultrasoundguided CNB were retrospectively analyzed, and the results of CNB pathology were compared with postoperative wax pathology results. ResultsAll patients completed CNB successfully and satisfaction rate for tissue samples was 100%. After CNB, local hematoma occurred in two cases and relieved by conservative therapy. The CNB pathology results of 347 cases of patients were as follows: 117 cases were malignancy, including papillary thyroid cancer in 115 cases, undifferentiated adenocarcinoma in 1 case, and squamous cell carcinoma in 1 case; 230 cases were benign, including thyroiditis in 53 cases, and nodular goiter in 141 cases, adenoma in 16 cases, and nodular goitre coexisting thyroiditis in 20 cases. In 132 cases of patients underwent surgery including 113 cases of malignancy and 19 cases of benign disease, the CNB pathology results in 127 cases were consistent with postoperative wax pathology results and false negative occurred in 5 cases. The diameter of thyroid nodules were not more than 0.5 cm in 4 cases, 0.5-1.0 cm in 59 cases, 1-2 cm in 46 cases, and more than 2 cm in 23 cases, and the accuracy rate of CNB pathology results was 75.0%（3/4）, 98.3%（58/59）, 97.8%（45/46）, and 91.3%（21/23）, respectively, which was the highest in 0.5-2.0 cm. The accuracy, sensibility, specificity, positive predictive value, negative predictive value, failure rate, and misdiagnosis rate of ultrasound-guided CNB for differential diagnosis of thyroid malignant nodules from benign nodules were 96.21% (127/132), 95.76% (113/118), 100% (14/14), 1 (113/113), 0.74 (14/19), 4.24%(5/118), and 0 (0/14), respectively. ConclusionUltrasound-guided CNB has important value on differential diagnosis of thyroid nodules, and important guiding significance on treatment of thyroid diseases.

Citation： ZHANG Guang,BIAN Xuehai,ZHANG Chunhai,FU Yantao,ZHAO Tao,SUN Hui,.. Significance of UltrasoundGuided Core Needle Biopsy in Diagnosis of Thyroid Nodules. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(8): 815-818. doi: Copy

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14.	刘思怡，蔡永秋，吴绍锋．甲状腺癌的二维及彩色多普勒超声诊断 [J]．中国医药导报， 2008， 5（20）： 101102．.
15.	Moon WJ, Jung SL, Lee JH, et al. Benign and malignant thyroid nodules: us differentiationmulticenter retrospective study [J]. Radiology, 2008, 247(3): 762770.
16.	张广，边学海，赵涛，等．超声引导下微创组织活检技术在甲状腺外科的应用 [J]．国际外科学杂志， 2010， 37（2）： 7981．.
17.	吴金声，郑起．甲状腺结节的良恶性鉴别进展 [J]．国外医学外科学分册， 2005， 32（4）： 297300．.
18.	郑宏庭，苏白海，方芳，等．细针穿刺细胞学检查甲状腺结节的临床评价 [J]．医学临床研究， 2008， 25（1）： 57．.
19.	吴亚群，张林，刘利敏．细针穿刺细胞学诊断甲状腺疾病的意义 [J]．临床外科杂志， 2008， 16（6）： 376377．.
20.	金玲，狄军艳，杨原，等． 240例甲状腺肿物细针吸取细胞学诊断分析 [J]．诊断病理学杂志， 2008， 15（3）： 199201．.
21.	Kessler A, Gavriel H, Zahav S, et al. Accuracy and consistency of fineneedle aspiration biopsy in the diagnosis and management of solitary thyroid nodules [J]. Isr Med Assoc J, 2005, 7(6): 371373.
22.	Cooper DS, Doherty GM, Haugen BR, et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer [J]. Thyroid, 2006, 16(2): 109142.
23.	赵光明，张雪鹏，马琳，等．彩色多普勒引导下甲状腺结节粗针穿刺活检的诊断意义 [J]．实用癌症杂志， 2004， 19（4）： 420421．.
24.	Lee TI, Yang HJ, Lin SY, et al. The accuracy of fineneedle aspiration biopsy and frozen section in patients with thyroid cancer [J]. Thyroid, 2002, 12(7): 619626.
25.	谢朝艳，杜心芳，顾世明．超声引导粗针活检技术在甲状腺肿块诊断中的价值 [J]．临床医学， 2007， 27（1）： 89．.
26.	苗立英，吕国荣，张武，等．介入性超声在甲状腺疾病诊断和治疗中的应用 [J]．中国超声医学杂志， 2000， 16（12）： 910912．.

1. Tae HJ, Lim DJ, Baek KH, et al. Diagnostic value of ultrasonography to distinguish between benign and malignant lesions in the management of thyroid nodules [J]. Thyroid, 2007, 17(5): 461466.
2. Davies L, Welch HG. Increasing incidence of thyroid cancer in the united states, 19732002 [J]. JAMA, 2006, 295(18): 21642167.
3. 向俊，吴毅．甲状腺癌临床诊治新特点（附572例临床分析） [J]．中国实用外科杂志， 2008， 28（5）： 365367．.
4. 郑泽霖，孙辉，盖宝东．甲状腺疾病外科治疗的热点和难点 [J]．中国普外基础与临床杂志， 2008， 15（5）： 307310．.
5. 吴雨雷，孟彦，戴玉姣．甲状腺微小癌诊疗分析 [J]．山西医药杂志， 2008， 37（11）： 10451046．.
6. Lin JD, Kuo SF, Chao TC, et al. Incidental and nonincidental papillary thyroid microcarcinoma [J]. Ann Surg Oncol, 2008, 15(8): 22872292.
7. Grodski S, Delbridge L. An update on papillary microcarcinoma [J]. Curr Opin Oncol, 2009, 21(1): 14.
8. 徐晓波，刘文勇．结节性甲状腺肿合并甲状腺微小癌42例分析 [J]．中国普外基础与临床杂志， 2011， 18（2）： 196197．.
9. Besic N, Pilko G, Petric R, et al. Papillary thyroid microcarcinoma:prognostic factors and treatment [J]. J Surg Oncol, 2008, 97(3): 221225.
10. Chung YS, Kim JY, Bae JS, et al. Lateral lymph node metastasis in papillary thyroid carcinoma:results of therapeutic lymph node dissection [J]. Thyroid, 2009, 19(3): 241246.
11. Lim YC, Choi EC, Yoon YH, et al. Central lymph node metastases in unilateral papillary thyroid microcarcinoma [J]. Br J Surg, 2009, 96(3): 253257.
12. 张建明，苏艳军，刁畅，等．甲状腺微小乳头状癌颈淋巴结清扫的临床研究 [J]．中国普外基础与临床杂志， 2011， 18（4）： 414418．.
13. 宋海霞，李淑玲，房秀霞，等．超声对甲状腺恶性肿瘤的诊断探讨 [J]．内蒙古医学杂志， 2008， 40（1）： 2930．.
14. 刘思怡，蔡永秋，吴绍锋．甲状腺癌的二维及彩色多普勒超声诊断 [J]．中国医药导报， 2008， 5（20）： 101102．.
15. Moon WJ, Jung SL, Lee JH, et al. Benign and malignant thyroid nodules: us differentiationmulticenter retrospective study [J]. Radiology, 2008, 247(3): 762770.
16. 张广，边学海，赵涛，等．超声引导下微创组织活检技术在甲状腺外科的应用 [J]．国际外科学杂志， 2010， 37（2）： 7981．.
17. 吴金声，郑起．甲状腺结节的良恶性鉴别进展 [J]．国外医学外科学分册， 2005， 32（4）： 297300．.
18. 郑宏庭，苏白海，方芳，等．细针穿刺细胞学检查甲状腺结节的临床评价 [J]．医学临床研究， 2008， 25（1）： 57．.
19. 吴亚群，张林，刘利敏．细针穿刺细胞学诊断甲状腺疾病的意义 [J]．临床外科杂志， 2008， 16（6）： 376377．.
20. 金玲，狄军艳，杨原，等． 240例甲状腺肿物细针吸取细胞学诊断分析 [J]．诊断病理学杂志， 2008， 15（3）： 199201．.
21. Kessler A, Gavriel H, Zahav S, et al. Accuracy and consistency of fineneedle aspiration biopsy in the diagnosis and management of solitary thyroid nodules [J]. Isr Med Assoc J, 2005, 7(6): 371373.
22. Cooper DS, Doherty GM, Haugen BR, et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer [J]. Thyroid, 2006, 16(2): 109142.
23. 赵光明，张雪鹏，马琳，等．彩色多普勒引导下甲状腺结节粗针穿刺活检的诊断意义 [J]．实用癌症杂志， 2004， 19（4）： 420421．.
24. Lee TI, Yang HJ, Lin SY, et al. The accuracy of fineneedle aspiration biopsy and frozen section in patients with thyroid cancer [J]. Thyroid, 2002, 12(7): 619626.
25. 谢朝艳，杜心芳，顾世明．超声引导粗针活检技术在甲状腺肿块诊断中的价值 [J]．临床医学， 2007， 27（1）： 89．.
26. 苗立英，吕国荣，张武，等．介入性超声在甲状腺疾病诊断和治疗中的应用 [J]．中国超声医学杂志， 2000， 16（12）： 910912．.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Significance of UltrasoundGuided Core Needle Biopsy in Diagnosis of Thyroid Nodules

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