| Objective:To investigate the diagnostic value of ultrasound-guided fine-needle aspiration(US-FNA)for thyroid nodules and to analyze the influence of nodule characteristics on the satisfaction of US-FNA results.To study the clinical significance of thyroglobulin in fine-needle aspirate fluid(FNA-Tg)determination in cervical lymph node metastasis or recurrence of thyroid cancer.Methods:263 patients with US-FNA from October 2016 to December 2018 were selected and305 nodules were enrolled in the study.According to Bethesda System classification criteria,the diagnostic value of US-FNA in thyroid nodules was analyzed by comparing the results of US-FNA cytology with those of pathology after operation.the results of US-FNA were unsatisfactory in Bethesda Ⅰ.To analyze the imaging characteristics of thyroid nodules:(elastic hardness,size,location,calcification type,calcification ratio,solid ratio)on the satisfaction of US-FNA results.A total of 29 suspected cervical metastatic lymph nodes were included in the study in all 26 patients undergoing FNA-Tg.The diagnostic value of FNA-Tg in cervical metastatic lymph nodes of thyroid cancer was analyzed based on pathological results.Results:1.The diagnostic value of US-FNA for benign and malignant thyroid nodules:sensitivity,specificity and accuracy were 79.68%(98/123),98.57%(69/70)and 86.53%(167/193),respectively.2.Analysis of imaging characteristics of thyroid nodules affecting US-FNA results:(1)Elastic hardness: The highest unsatisfactory rate of US-FNA was 29.71%(41/138)in group Ⅰb(≥grade 4).(2)Size: The highest unsatisfactory rate of US-FNA was 36.67(44/120)in group Ⅱa(0.5cm≤d<1cm).(3)Location: The highest unsatisfactory rate of US-FNA was 37.84(28/74)in groupⅢc(deep layer).(4)Calcification types: The highest unsatisfactory rate of US-FNA was 46.77(29/62)in group Ⅳc(crude calcification).(5)Calcification ratio: The unsatisfactory rates of US-FNA results in group Ⅴd(50%<Ca≤75%)and group Ⅴe(75%<Ca≤100%)were higher,78.95%(15/19),72.73%(8/11),respectively.(6)Solid ratio:The unsatisfactory rates of US-FNA results in group Ⅵa(0%<So≤25%)and group Ⅵb(25% < So ≤ 50%)were higher,83.33%(5/6),66.67%(4/6),respectively.(7)Multivariate analysis of US-FNA results in thyroid nodules:The parameters influencing the results of US-FNA by multivariate logistic regression analysis are: elastic hardness(≥grade 4),size(0.5cm≤d<1cm),location(deep layer),calcification(coarse calcification),calcification ratio(50%<Ca≤ 75%),solid ratio(0%<So≤25%)and solid ratio(25%<So≤50%).3.The diagnostic value of US-FNA in cervical metastatic lymph nodes of thyroid cancer: accuracy,sensitivity and specificity were 76.47%(13/17),66.67%(8/12)and100.00%(5/5),respectively.4.The diagnostic value of FNA-Tg in cervical metastatic lymph nodes of thyroid cancer: accuracy,sensitivity and specificity were 100.00%(29/29),100.00%(18/18)and100.00%(11/11),respectively.Conclusion:1.US-FNA has high diagnostic value in the differential diagnosis of benign and malignant thyroid nodules.2.When thyroid nodules are small(0.5cm ≤ d < 1cm),hard(≥ grade 4),deep,coarse calcification,more calcification(>50%)and less solid(≤50%),the satisfaction of US-FNA specimens will be affected to a certain extent.3.The determination of FNA-Tg in eluent has high diagnostic value in the diagnosis of cervical lymph node metastasis of thyroid cancer. |
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