Shanghai Jiaotong Daxue xuebao. Yixue ban (Aug 2023)

Study on ultrasound-guided thyroid fine needle puncture assisted by rapid on-side evaluation

  • HE Yujie,
  • FAN Linrui,
  • ZHANG Qiaochu,
  • ZHANG Zhili,
  • DING Jun,
  • SHI Chao,
  • YAO Yongqiang,
  • REN Hongzheng

DOI
https://doi.org/10.3969/j.issn.1674-8115.2023.08.011
Journal volume & issue
Vol. 43, no. 8
pp. 1032 – 1037

Abstract

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Objective·To explore the clinical effect of ultrasound-guided fine needle aspiration cytology assisted by rapid on-side evaluation (ROSE).Methods·The data of patients with thyroid nodules diagnosed in Gongli Hospital of Shanghai Pudong New Area from January 2019 to December 2022 were retrospectively analyzed (n=874). According to cytological detection methods, they were divided into ROSE+thinprep cytologic test (TCT) group (n=469) and cell smear (CS)+TCT group (n=405). In the ROSE+TCT group, the tissue and cell samples of ROSE were detected by Diff-Quik staining and continue puncturing until the specimen was satisfied. In the CS+TCT group, the tissue and cell samples were detected by hematoxylin-eosin staining (H-E staining) + Pap staining. Cytologic diagnosis was made according to The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) cytologic classification criteria, and the cell dissatisfaction rates and clinical outcomes of the 2 methods were compared.Results·The dissatisfaction rates of the ROSE+TCT group and CS+TCT group were 2.4% and 14.1%, respectively, with statistical significance (P=0.000). The smear cells of the ROSE+TCT group were concentrated, and the structure was clear and easy to observe. The samples with a cytologic diagnosis of grade Ⅲ and above were prepared as cell wax blocks to improve the efficiency of subsequent diagnosis. The cells of the CS+TCT group could not produce wax blocks due to the small numbers of cells. The puncture times of the ROSE+TCT group were significantly different from that of the CS+TCT group (P=0.011).Conclusion·The ultrasound-guided thyroid fine needle aspiration assisted by rapid on-site assessment method can assess the effective number of cells in the specimen on the spot, give feedback to the puncturing doctors on the spot, meet the diagnostic accuracy requirements of pathologists by collecting a sufficient number of cells, reduce the number of punctures and treatment time, and play a good auxiliary role in the diagnosis and follow-up examination of clinicians.

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