Clinical Study Between Fine Needle Aspiration Cytology And Fine Needle Capillary Cytology In The Diagnosis Of Thyroid Nodules

Objectives:To compare the clinical application value between fine needle aspiration cytology(FNAC)and fine needle capillary cytology(FNCC)in the diagnosis of benign and malignant thyroid nodules.Methods:Thisstudy selected143patientswith thyroidnodulesundergoing ultrasound-guided fine needle aspiration cytology in our hospital from January 2017to December 2017.There were 152 nodules in total.All the nodules were confirmed by postoperative pathology.FNAC and FNCC were performed on 152 thyroid nodules simultaneously.The Mair scoring system was used to assess the difference in the quality of the sample obtained between FNAC and FNCC.With postoperative pathology as the diagnostic criteria,FNAC diagnostic results of the 152 cases of thyroid nodules,FNCC diagnostic results and the combined diagnosis of the two were compared with postoperative pathological results.Compare the diagnostic differences between FNAC and FNCC.Compare the sensitivity,the specificity and the accuracy of FNAC(or FNCC)with both.Statistical analyses were performed using the SPSS17.0 statistical software package,measurement data using wilcoxon signed-rank test,count data using X~2 test,P values<0.05 were considered statistically significant,P values<0.001 were considered statistically highly significant.Results:In the samples quality,a highly significant differences(P<0.001)in favor of FNAC was observed for cellular material and retention of architecture while total score favored FNCC for the background blood or clot,cellular degeneration and degree of cellular trauma.In the 152 cases of thyroid nodules,there were 107 cases of malignant nodules and 45 cases of benign nodules.97 cases of malignant nodules and40 cases of benign nodules were diagnosed correctly for FNAC,the sensitivity was90.7%,the specificity was 88.9%,the accuracy was 90.1%;96 cases of malignant nodules and 38 cases of benign nodules cases were diagnosed correctly for FNCC,the sensitivity was 89.7%,the specificity was 84.4%,the accuracy was 88.2%;104 cases of malignant nodules and 43 cases of benign nodules were diagnosed with the combined method of the two,the sensitivity was 97.2%,the specificity was 95.6%,the accuracy was 96.7%.In the diagnostic performance,the difference was not statistically significant(P=0.678>0.05)for FNAC and FNCC by McNemar test.The sensitivity was compared FNAC with the both combined,X~2=4.013,P<0.05,the difference was statistically significant.Comparing the specificity of the two groups,X~2=0.62,P>0.05,the difference was not statistically significant.Comparing the accuracy of the two groups,X~2=5.352,P<0.05,the difference was statistically significant.The sensitivity was compared FNCC with the both combined,X~2=4.891,P<0.05,the difference was statistically significant.Comparing the specificity of the two groups,X~2=1.975,P>0.05,the difference was not statistically significant.Comparing the accuracy of the two groups,X~2=7.949,P<0.05,the difference was statistically significant.Conclusions:(1)FNAC is more advantageous in the cellular material and retention of architecture,clinically more suitable for cystic and solid nodules and more calcified or harder thyroid nodules;(2)FNCC is more advantageous in the background blood or clot,cellular degeneration and degree of cellular trauma,clinically more suitable for blood-rich thyroid nodules;(3)There was no difference in the identification of benign and malignant thyroid nodules for FNAC or FNCC;(4)For the same nodule,FNAC and FNCC combined application can improve the diagnostic accuracy of thyroid cancer.