细针穿刺与穿刺洗脱液甲状腺球蛋白定量在侧颈区肿大淋巴结定性诊断中应用  

Diagnostic Value of Fine-needle Aspiration and Thyroglobulin Measurement in Fine-needle Aspiration for Node Metastasis in Thyroid Carcinoma Before Thyroidectomy

作　　者：李强[1] 赵博文[1] 吕江红[1] 寿金朵[1] 徐海珊[1] 楼海亚[1] 朱江[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院超声科,杭州市310016

出　　处：《中国超声医学杂志》2016年第5期400-403,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的评价细针穿刺(FNA)与穿刺洗脱液中甲状腺球蛋白(FNA-Tg)在诊断甲状腺癌术前侧颈区可疑肿大淋巴结中的应用价值。方法对声像图显示为可疑肿大的淋巴结进行FNA及FNA-Tg测定,以手术病理为金标准,绘制ROC曲线求取FNA-Tg最佳诊断阈值,比较FNA、FNA-Tg及两者联合对可疑肿大淋巴结的诊断效能。结果 FNA-Tg对该组淋巴结的最佳诊断阈值为26.5μg/L,曲线面积为0.916;FNA-Tg与FNA比较,灵敏度及阴性预测值差异有统计学意义(P=0.014、0.024);两者联合与FNA比较,灵敏度、准确度及阴性预测值差异有统计学意义(P=0.013、0.036、0.016)。结论 FNA-Tg是诊断转移性淋巴结的重要方法,FNA联合FNA-Tg后显著提高了FNA诊断的灵敏度、准确度,在FNA中具有重要意义。Objective To evaluate the diagnostic value of ultrasound guided fine needle aspirate（FNA）and thyroglobulin measurement in fine-needle aspiration（FNA-Tg）for detecting lateral neck node metastasis in patients with thyroid carcinoma before thyroidectomy.Methods FNA and FNA-Tg for suspicious enlarged lymph nodes were performed.Postoperative pathologic results were taken as the gold standard.To obtain the optimal threshold value for diagnosis of FNA-Tg ROC curve,the diagnostic efficiency of FNA,FNA-Tg and the combination were compared.Results The best diagnostic threshold of FNA-Tg for suspicious metastatic lymph nodes was 26.5μg/L,the Area under ROC curve of FNA-Tg was 0.916.When the FNA-Tg compared with FNA,the sensitivity and negative predictive value were statistically significant.When the combinaion diagnosis compared with single FNA,the sensitivity,accuracy and negative predictive value were statistically significant.Conclusions FNA-Tg is an important method for the diagnosis of metastatic lymph node.FNA-Tg raised the sensitivity,accuracy of FNA method and plays an important role in diagnosing metastatic lymph node via FNA.

关 键 词：超声检查 甲状腺肿瘤 活组织检查 细针 淋巴转移 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]