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首页> 外文期刊>Diagnostic cytopathology >A comparative study of 200 head and neck FNAs performed by a cytopathologist with versus without ultrasound guidance: evidence for improved diagnostic value with ultrasound guidance.
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A comparative study of 200 head and neck FNAs performed by a cytopathologist with versus without ultrasound guidance: evidence for improved diagnostic value with ultrasound guidance.

机译：由细胞病理学家对有无超声引导下和无超声引导下进行的200例头部和颈部FNA的比较研究：证据表明超声引导下诊断价值得到改善。

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Our previous study showed that the sensitivity of head and neck fine-needle aspiration (FNA) procedures was significantly better in the cytopathologist-performed group than in the noncytopathologist-performed group (96 versus 67%). Recently, cytopathologists have learned to use ultrasound machines to assist them in performing FNA procedures. This study was designed to assess whether cytopathologist-performed FNAs with ultrasound guidance can improve diagnostic value in comparison to those done without ultrasound guidance. Two hundred consecutive head and neck FNA cases performed by the same cytopathologist with and without ultrasound guidance were reviewed. Cases consisted of 100 ultrasound-guided FNAs (USGFNAs) performed between July 2008 and March 2009 and 100 palpation-guided FNAs (PGFNAs) performed before July 2008. These cases were correlated with follow-up surgical diagnosis. The diagnostic, suspicious/atypical/suggestive, and nondiagnostic rates (%) for the head and neck FNAs were 83 versus 86, 10 versus 13, and 7 versus 1 in PGFNA group versus USGFNA group, respectively. Surgical follow-up specimens were found in 50 PGFNAs versus 35 USGFNAs. The true-positive, true-negative, false-positive, and false-negative rates (%) were 92, 2, 2, and 4 versus 80, 17, 3, and 0 in PGFNAs versus USGFNAs, respectively. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 96, 50, 98, 33, and 94% in PGFNAs versus 100, 86, 97, 100, and 97% in the USGFNA group, respectively. This study also shows increased FNAs of thyroid and salivary glands and other smaller nonpalpable lesions with ultrasound guidance. USGFNAs performed by a cytopathologist could significantly improve the specificity and NPV (P = 0.04) while preserving virtually the same excellent sensitivity and PPV as those of PGFNAs. With ultrasound guidance, a cytopathologist will be able to perform FNAs in smaller, nonpalpable lesions and target complex lesions with confidence and accuracy, thus achieving a better outcome.
机译：我们之前的研究表明，在进行细胞病理学家检查的小组中，头颈部细针穿刺术（FNA）的敏感性要明显好于未进行细胞病理学家检查的小组（96％对67％）。最近，细胞病理学家已经学会了使用超声波机器来协助他们执行FNA程序。这项研究旨在评估与没有超声引导的情况相比，在超声引导下进行细胞病理学检查的FNA是否可以提高诊断价值。回顾了由同一细胞病理学家在有无超声引导下连续进行的头颈FNA病例200例。病例包括在2008年7月至2009年3月之间进行的100例超声引导下FNA（USGFNA）和在2008年7月之前进行的100例触诊下引导下FNA（PGFNA）。这些病例与后续手术诊断相关。 PGFNA组与USGFNA组的头颈部FNA的诊断率，可疑/非典型/建议性和非诊断率（％）分别为83对86、10对13、7对1。在50个PGFNA和35个USGFNA中发现了手术随访标本。在PGFNA与USGFNA中，真阳性率，真阴性率，假阳性率和假阴性率（％）分别为92、2、2和4，而80、17、3和0分别为。 PGFNA中的敏感性，特异性，阳性预测值（PPV），阴性预测值（NPV）和准确性分别为96％，50％，98％，33％和94％，而USGFNA中的敏感性分别为100％，86％，97％，100％和97％组。这项研究还显示，在超声引导下，甲状腺和唾液腺以及其他较小的不可触及病变的FNA增加。由细胞病理学家进行的USGFNA可以显着提高特异性和NPV（P = 0.04），同时保留与PGFNA几乎相同的优异灵敏度和PPV。借助超声引导，细胞病理学家将能够在较小的，不可触及的病变中执行FNA，并能自信而准确地靶向复杂病变，从而获得更好的结果。

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