超声引导下甲状腺结节细针穿刺活检的 6 种操作方法的比较.

Objective To compare the accuracy of six operative methods of ultrasound-guided fine-needle aspiration biopsy of thyroid nodules and to share the experience of the operation. Methods The data of 1903 patients who underwent thyroid surgery, pre-operative fine-needle biopsy (FNA) and definite pathological findings after surgery were included. The data of the above patients were divided into 6 groups：A1-A3, B1-B3 according to the angle of FNA needle insertion and sampling technique. category A for end-lateral and category B for side-lateral； category 1 for negative pressure aspiration, category 2 for normal pressure aspiration, and category 3 for closed pressure entry and exit. Based on the traditional evaluation indexes, the Bowker weighted test was used to compare their differences and the Kappa linear weighted test for consistency. The advantages and disadvantages of the six different operation methods were finally evaluated. Results Sensitivity: Category A was higher than category B. Highest in group A3；96.47% and lowest in group B2；87.69%；Specificity: all were 100%; Accuracy: category A was higher than category B subgroups, highest in group A3；97.69%，and lowest in group B2; 91.20%;Positive prediction rate: all were 100%；Negative prediction rate: category A was higher than class B subgroups. The highest A3 was 95.65% in group A3, and the lowest was 78.57% in group B2;Yordon index: higher in category A than in category B. The highest was 96.47% in group A3 and the lowest was 87.69% in group B2. Bowker’s weighted test results: the P -values were：A3 > A1 > A2 > B3 = B1 = B2.The P of A1, A2, B1, B2, and B3 < 0.01, statistically significantly different from postoperative histopathological results. The P-value of A3 was 0.072, P>0.05. There was no statistical difference with the postoperative histopathological result in A3；Kappa consistency test (linear weighted) results：A3 > A1 > A2 > B3 > B1 > B2; The highest value was 0.959 for the A3 group, and the lowest was 0.821 for the B2 group. Conclusions Based on the traditional evaluation index, paired chi-square and Kappa test results, the end-lateral approach with closed-pressure entry and exit sampling method (A3 group) have the closest cytologic pathology results to postoperative histologic pathology and is the best FNA approach with high sampling quality. [ABSTRACT FROM AUTHOR]