摘要
目的 探讨术前超声检查和细针穿刺活检、术中冰冻切片检查诊断甲状腺癌的准确度,并分析诊断准确度的影响因素.方法 选取103例甲状腺疾病患者,行术前超声检查及细针穿刺活检、术中冰冻切片及术后病理检查,比较术前超声检查及细针穿刺活检、术中冰冻切片检查对甲状腺癌的诊断准确度.术前超声检查及细针穿刺活检、术中冰冻切片检查诊断甲状腺癌准确度的影响因素采用多因素Logistic回归分析.结果 103例甲状腺疾病患者术后病理检查均为甲状腺癌.术前超声检查、术前细针穿刺活检、术中冰冻切片诊断甲状腺癌的准确度分别为81.55%(84/103)、94.17%(97/103)、97.09%(100/103).多因素Logistic回归分析结果显示,肿瘤直径≤1 cm为术前超声检查诊断甲状腺癌准确度的独立危险因素(P﹤0.05),是否参考超声参数及诊断不是术前细针穿刺活检诊断甲状腺癌准确度的影响因素(P﹥0.05),有明显伴随炎症为术前细针穿刺活检诊断甲状腺癌准确度的独立危险因素(P﹤0.05).结论 术前细针穿刺活检、术中冰冻切片检查诊断甲状腺癌的准确度均高于术前超声检查,肿瘤直径≤1 cm为术前超声检查诊断甲状腺癌准确度的独立危险因素,有明显伴随炎症为术前细针穿刺活检诊断甲状腺癌准确度的独立危险因素.
Abstract
Objective To explore the accuracy of preoperative ultrasound examination,fine-needle aspiration biopsy,and intraoperative frozen section examination in diagnosing thyroid cancer,and to analyze the influencing factors of accu-racy.Method A total of 103 patients with thyroid disease were selected,and underwent preoperative ultrasound exami-nation,preoperative fine-needle aspiration biopsy,intraoperative frozen section,and postoperative pathological examina-tion.The diagnostic accuracy of preoperative ultrasound examination,preoperative fine-needle aspiration biopsy,and in-traoperative frozen section for thyroid cancer was compared.The influencing factors of the accuracy of preoperative ultra-sound examination,preoperative fine-needle aspiration biopsy,and intraoperative frozen section examination in diagnos-ing thyroid cancer were analyzed by multivariate Logistic regression.Result Postoperative pathological examination showed that among 103 patients with thyroid disease were thyroid cancer.The accuracy of preoperative ultrasound exami-nation,preoperative fine-needle aspiration biopsy,and intraoperative frozen section in diagnosing thyroid cancer were 81.55%(84/103),94.17%(97/103),and 97.09%(100/103),respectively.Multivariate Logistic regression showed that tu-mor diameter≤1 cm was independent risk factor for the accuracy of preoperative ultrasound examination in diagnosis of thyroid cancer(P<0.05),whether to refer the ultrasound parameters and diagnosis was not influencing factor for the accu-racy of preoperative fine-needle aspiration biopsy in diagnosis of thyroid cancer(P>0.05),the obvious accompanying in-flammation was independent risk factor for the accuracy of preoperative fine-needle aspiration biopsy in diagnosis of thy-roid cancer(P<0.05).Conclusion The accuracy of preoperative-fine needle aspiration biopsy and intraoperative frozen section examination in diagnosing thyroid cancer are higher than that of preoperative ultrasound examination,the tumor diameter≤1 cm is independent risk factor for the accuracy of preoperative ultrasound examination,and the obvious ac-companying inflammation is independent risk factor for the accuracy of preoperative fine-needle aspiration thyroid cancer.
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