目的    探讨无负压细针穿刺技术在甲状腺结节诊断中的应用价值。方法    吉林大学中日联谊医院甲状腺外科自2012年5月至2012年10月 在超声引导下采用无负压细针穿刺技术对甲状腺结节行细胞学活检，将该结果与术后石蜡病理检查结果进行对比研究。 结果    共行穿刺350例（计甲状腺结节394个），标本无法诊断或不满意35个（9%），良性138个（35%），意义不明的细胞非典型性病变或滤泡性病变56个（14%），无滤泡性肿瘤或可疑滤泡性肿瘤，可疑恶性肿瘤30个（8%），恶性肿瘤135个（34%，其中乳头状癌133个，髓样癌2个）。经手术后病理组织学检查对照 159个，其敏感度为88%，特异度为79%。排除前50例操作学习曲线的影响后，其敏感度为93%，特异度为76%。穿刺过程中发生局部小血肿7例，无严重并发症。结论    改良的超声引导下无负压细针穿刺检查能满足病理检查取材要求，操作简单；该技术的开展经过一定的学习曲线可明显提高甲状腺结节诊断敏感性。

Application of ultrasound-guided fine-needle capillary cytology in diagnose of thyroid nodules：A report of 350 cases        ZHOU Le,ZHANG Guang, HAN Jing,et al. Department of Thyroid Surgery, China-Japan Union Hospital, Jilin University，Changchun 130033,China
Corresponding author:SUN Hui, E-mail:sunhui1229@163.com
Abstract    Ojective    To investigate the technique and method to improve the successful rate of thyroid nodule puncture biopsy. Method    We used ultrasound-guided fine-needle capillary cytology with multi-faceted pulling approach for thyroid nodule biopsy. The result was compared with post-operative paraffin pathological findings. Result  A total of 350 cases(394 thyroid nodules) with biopsy results were involved, in which specimen of 35 nodules (9%) can not be diagnosed or dissatisfied; in the rest,138 nodules of benign, 56 nodules of undetermined atypical cells lesions or follicular lesions, none of follicular or suspicious follicular neoplasm, 30 nodules of suspicious malignancy, and 135 nodules of malignancy(34%, 133 nodules of papillary carcinoma, 2 nodules of medullary carcinoma). Compared with post-operative histopathology findings of 159 nodules, the sensitivity and the specificity were 88% and 79%. After the first 50 cases were excluded for the effect of the learning curve, the sensitivity and the specificity reached to 93% and 76%. 7 cases occurred local tiny hematoma during operation .No serious complication occurred. Conclusion    The reformed ultrasound-guided fine-needle capillary cytology meets the requirements of drawing matieral and simply operating ; after a period of learning curve, the technology would help to significantly improve the diagnostic sensitivity of thyroid nodules.