A Comparative Study Of Ultrasound-guided Fine Needle Aspiration Cytology And Core Needle Biopsy Histology In The Diagnosis Of Thyroid Nodules

Objective: To compare Ultrasound-guided fine needle aspiration cytology(US-FNA)and Ultrasound-guided core needle biopsy histology(US-CNB)in the diagnosis of benign and malignant thyroid nodules.Methods:72 patients with thyroid nodules were selected from February 2019 to June 2019,all the nodules underwent US-FNA and US-CNB.Cytology and histopathology were compared with postoperative pathology which as the gold standard,And the influence of the size(Maximum diameter?1 cm group;Maximum diameter>1cm group),location(peripheral group;central group),blood flow situation(multiple blood supply group;other blood supply group)and calcification(coarse calcification group;other calcification groups)of thyroid nodules on the diagnostic ability of US-FNA and US-CNB were compared respectively.Results: In the overall comparison between US-FNA and US-CNB,The accuracy,sensitivity,specificity,positive predictive value,negative predictive value of US-FNA and US-CNB were respectively as follows: 84.29%/95.71%;80.77%/96.15%;94.44%/94.44%;97.67%/98.04%;62.96%/89.47%.The accuracy,sensitivity were significantly different(P=0.024,P=0.014).In the comparison of the affecting of various factors on the diagnosis results of US-FNA,The accuracy,sensitivity,negative predictive value of“central group”was higher than that of “peripheral group”(P=0.002,P=0.001,P=0.001);the accuracy,sensitivity of“other blood supply group”was higher than that of“multiple blood supply group”(P=0.000,P=0.000);the accuracy and sensitivity of“other calcified groups”were higher than those of“coarse calcification group”(P=0.001,P=0.000).The size of the nodule had no effect on the diagnosis of US-FNA.However,in the comparison of the affecting of various factors on the diagnosis results of US-CNB,the accuracy and negative predictive value of the“central group”were higher than those of the“peripheral group”(P=0.017,P=0.015),while the size,blood supply and calcification of the nodules did notaffect the diagnosis results of US-CNB.And the sensitivity of US-CNB in the“peripheral group”and “multiple blood supply group”was higher than that of US-FNA(P=0.048,P=0.029);the accuracy and the sensitivity of US-CNB in the“coarse calcification group”were higher than that of US-FNA(P=0.017,P=0.009).There was no difference in the diagnosis of US-FNA and US-CNB between “ Maximum diameter?1cm group ”,“Maximum diameter>1cm group”,“central group”,“non-multiple blood supply group”and“other calcification groups”.Multivariate logical regression analysis of the factors influencing the diagnostic accuracy of US-FNA and US-CNB showed that the difference was not statistically significant(p>0.05).Conclusion:US-CNB is of great value in the diagnosis of thyroid nodules.However,US-FNA is more suitable choice for most nodules.When the US-FNA cannot clearly diagnose,the US-CNB can be used as a further test.