细针穿刺洗脱液测定甲状腺球蛋白鉴别转移淋巴结性质  

Diagnosing cervical lymph node metastasis from papillary thyroid cancer by thyroglobulin measurement in fine-needle aspiration washout fluid

作　　者：周好[1] 陈海珍[1] 陈曦[1] 余宁康[2] 陈诚[2] 吴志浩[2] 李宏为[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院外科,上海200025 [2]上海交通大学医学院附属瑞金医院远洋分院外科,上海200031

出　　处：《外科理论与实践》2012年第1期17-20,共4页Journal of Surgery Concepts & Practice

摘　　要：目的:临床研究通过细针穿刺洗脱液测定甲状腺球蛋白水平鉴别甲状腺乳头状癌颈部淋巴结性质的可行性。方法:20例甲状腺乳头状癌伴明显颈部淋巴结转移的病人,术中对切除甲状腺和颈部淋巴结行直视下细针穿刺,对穿刺洗脱液行甲状腺球蛋白(Tg)的测定,并与病理检查结果比对。结果:甲状腺内乳头状癌病灶的穿刺洗脱液Tg值中位数为84.4(19.0～446.1)ng/mL,甲状腺良性组织的穿刺洗脱液Tg值中位数为133.4(16.0～558.3)ng/mL,两者比较无统计学差异。直径>1 cm的转移性淋巴结穿刺洗脱液Tg值中位数为78.0(14.9～1000.0)ng/mL,显著高于直径>1 cm的反应性增生淋巴结穿刺洗脱液Tg值[0.1(0.1～1.3)ng/mL]。直径<1 cm的转移性淋巴结穿刺洗脱液Tg值中位数为45.9(8.0～352.0)ng/mL,显著高于直径<1 cm的反应性增生淋巴结穿刺洗脱液Tg值[0.1(0.1～2.1)ng/mL]。同样为转移淋巴结,直径>1 cm的穿刺洗脱液Tg值明显高于直径<1 cm的Tg值。淋巴结穿刺洗脱液Tg值与血清Tg值和血清TgAb值无相关性。结论:细针穿刺洗脱液测Tg水平对明确颈部淋巴结是否为甲状腺乳头状癌转移有积极的意义,值得推广开展。Objective To investigate the feasibility of diagnosing cervical lymph node metastasis from papillary thyroid carcinoma（PTC） by thyroglobulin（Tg） assessment in fine-needle aspiration washout fluid.Methods Twenty patients with cervical lymph node metastasis from PTC were submitted to surgery department.The PTC lesions and enlarged lymph nodes were aspirated by fine-needle with Tg in washout fluid assayed and were diagonized pathologically.Results Among the cases,the median values of Tg in PTC [84.4（19.0-446.1） ng/mL] did not differ from that in normal tissue [133.4（16.0-558.3 ng/mL].For the lymph node with diameter 1 cm,the level of Tg from metastatic lymph nodes [78.0（14.9-1000.0） ng/mL] was significantly higher than that from inflammatory lymph nodes [0.1（0.1-1.3） ng/mL].Similar results were observed for the lymph nodes with diameter 1 cm [45.9（8.0～352.0） vs 0.1（0.1～2.1） ng/mL].Tg from metastatic lymph nodes 1 cm was significantly higher than that from metastatic lymph nods 1 cm.However,no correlation was observed between Tg values in fine-needle washout and that in serum or the level of Tg antibody in serum.Conclusions Tg measurement in fine-needle aspiration washout fluid is effective to identify the characteristics of cervical lymph node in PTC patients.

关 键 词：甲状腺乳头状癌 细针穿刺 甲状腺球蛋白 淋巴结转移 

分 类 号：R736.1[医药卫生—肿瘤]