The Study Of Ultrasound-guided Thyroid Fine Needle Aspiration Cytology On The Clinical Value Of ≤1cm Suspected Malignant Nodules

Objective:To explore the diagnostic value of ultrasound guided fine-needle aspiration cytology of ≤1cm suspected malignant nodules.Methods:Methods from September 2015 to June 2016,64 patients with malignant thyroid nodules diagnosed by ultrasound and hospitalized in Guangzhou No.1 People’s Hospital were collected,all patients underwent ultrasound-guided fine-needle aspiration cytology,and nodule diameter is less than or equal to 1cm.The positive standard for US-FNAC diagnosis is post operation pathology,The negative standard for US-FNAC diagnosis were followed up ultrasound for 1 years or post operation pathology.The fine needle aspiration was performed by the same ultrasonic surgeon,and the result was interpreted by the same pathologist.By analyzing of the puncture results and the operation pathology and follow-up results,to compare the consistency and value of US-FNAC diagnosis.Results:In 64 patients,all patients were complete,among which 14 cases were male(21.88%),50(78.13%)cases of female,aged between 17 to 66 years old,the average(42.89 + 12.09)years old.The diameter of the nodules was 4 ~ 10 mm.FNAC diagnosis of 43 cases(67.2%)of malignant patients,by pathology after the operation(gold standard)40 cases of malignant patients,including 38 cases of micro papillary carcinoma,follicular carcinoma in 2 cases;21 cases(32.8%)of benign patients diagnosed with FNAC,among which 7 cases were followed up for 1 years in the process of ultrasound in malignant signs of increased surgical confirmed papillary carcinoma,14 cases of illness in patients with no obvious change,classified as benign.The operation proved to be malignant in 47 patients,9 in males,and 38 in females.The FNAC diagnostic sensitivity,specificity,accuracy,positive predictive value,negative predictive value,false negativerate and false positive rate were 85.1%(40/47),82.4%(14/17),84.4%(54/64),93.1%(40/43),66.7%(14/21),14.9%(7/47),17.6%(3/17).Consistent with kappa test analysis of FNAC diagnosis and postoperative pathological results,statistical results show that the value of kappa=0.627,and P<0.001,according to α=0.05 test level,there was statistically significant difference.The area of ROC curve to evaluate FNAC in the diagnosis of ≤1cm suspected malignant nodules of the efficacy of AUC=0.827,and P<0.001,the difference has statistical significance.Conclusions:Compared with the postoperative pathological,FNAC,has a high diagnostic accuracy and consistency of ≤1cm suspected malignant nodules,can early detection of thyroid micro carcinoma,is an accurate and effective method to assess the ≤1cm suspected malignant nodules before surgery.