超声检查和病理测量甲状腺乳头状癌肿瘤大小的对比研究  

Consistency of tumor sizes measured by sonographic and pathological examination in papillary thyroid carcinoma

作　　者：王颖[1] 丁金旺[2] 韩志江[3] 雷志锴[4] 彭友[2] 张卧[2] 潘钢[2] 王炜[5] 罗定存[2] 楼军[6] 

机构地区：[1]松阳县人民医院超声科,浙江松阳323400 [2]南京医科大学附属杭州医院(杭州市第一人民医院)肿瘤外科,浙江杭州310006 [3]南京医科大学附属杭州医院(杭州市第一人民医院)放射科,浙江杭州310006 [4]南京医科大学附属杭州医院(杭州市第一人民医院)超声科,浙江杭州310006 [5]南京医科大学附属杭州医院(杭州市第一人民医院)病理科,浙江杭州310006 [6]杭州市肿瘤医院超声科,浙江杭州310002

出　　处：《中国耳鼻咽喉头颈外科》2017年第3期149-152,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：浙江省公益技术应用研究项目(2017C33180);浙江省医药卫生科技计划项目(2015KYB293);杭州市科技计划项目(20131813A08;20160533B05);杭州市医药卫生科技计划项目(2012A020;2014A02;2015A21)联合资助

摘　　要：目的比较超声检查和病理测量甲状腺乳头状癌(papillary thyroid carcinoma,PTC)肿瘤大小的差异,并分析其临床意义。方法选取2012年6月~2014年6月杭州市第一人民医院收治的PTC 114例(共122枚癌灶),昕有癌灶大小先后通过术前超声检查和术后组织病理测量确定,采用Pearson相关分析、配对t检验和Bland-Altman作图评价两种方法测量肿瘤大小的差异性和一致性。结果Pearson相关显示两种方法测量的肿瘤最大径存在显著正相关(r=0.957,P=0.000)。配对t检验显示肿瘤的超声最大径(8.24±5.06)mm与病理最大径(7.79±4.75)mm存在显著性差异。Bland-Altman分析显示,两种方法测量的肿瘤最大径的差值绝对值介于0~6.5 mm之间,平均(1.03±1.14)mm,差值的一致性界限(limits of agreement,LoA)为_2.41 mm^3.33 mm,LoA的95%置信区间为.2.87 mm^3.78 mm,LoA置信区间范围内差值的最大绝对值为2.9 mm。结论超声检查和病理测量PTC的肿瘤大小存在显著差异,两者的一致性欠佳,临床实践中应引起重视。OBJECTIVE The aim of the study was to evaluated the difference and consistency in tumor size measured by sonographic and pathological examination in papillary thyroid carcinoma（PTC）.METHODS A total of 114 patients with PTC, including 122 malignant nodules, was collected from Hangzhou First People＇s Hospital between Jun 2012 and Jun 2014. The tumor sizes were measured by preoperative sonographic and postoperative pathologic evaluation. Pearson correlation analysis, paired t-test, and Bland-Altman plot were used to evaluate the correlation and consistency in tumor size measured by the two methods.RESULTS Pearson correlation analysis showed that the largest tumor size measured by sonography were positively correlated with pathologic size （r=0.957, P=0.000）. Paired t-test showed that there were statistically difference between sonographic size and pathological size （8.24±5.06） mmvs （7.79±4.75） mm,P=0.001. The absolute difference value of the largest tumor size measured by the two methods was from zero to 6.5 mm, with the average of （1.03±1.14） mm. Bland-Altman analysis showed that the limits of agreement （LoA） of difference was from -2.41 mm to 3.33 mm, with the 95% confidence interval from -2.87 mm to 3.78 mm.Within the limit of the consistency, the maximum moduli was 2.9 mm.CONCLUSION There is a significant discrepancy between the preoperative sonographic and the pathologic size of the papillary thyroid carcinoma, which should be taken into account in clinical practice.

关 键 词：甲状腺肿瘤 超声检查 对比研究 肿瘤大小 一致性 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]