细针穿刺洗脱液甲状腺球蛋白测定诊断分化型甲状腺癌淋巴结转移  

Thyroglobulin measurement in fine-needle aspiration washout fluid for detection of differentiated thyroid cancer lymph nodes metastases

作　　者：齐淑轶[1] 邓莅霏[2] 谢梅[1] 朱雪清[1] 王一凤[2] 刘学明[2] QI Shuyi;DENGLifei;XIEMei;ZHUXueqing;WANG Yifeng;LIUXueming(Department of Pathology,Jiangxi Provincal Cancer Hospital,Nanchang,330029,China;Department of Head and Neck Surgery,Jiangxi Provincal Cancer Hospital)

机构地区：[1]江西省肿瘤医院病理科,南昌330029 [2]江西省肿瘤医院头颈外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2018年第19期1480-1482,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：江西省科技厅社发项目(No:20142BBG70079);江西省卫生厅科技计划项目(No:20141122)

摘　　要：目的:通过检测细针穿刺洗脱液中甲状腺球蛋白水平诊断分化型甲状腺癌颈淋巴结转移的可行性。方法:47例接受手术治疗的分化型甲状腺癌患者,术中对手术切除的颈淋巴结直视下细针穿刺并进行病理学诊断,同时对抽吸物的洗脱液进行甲状腺球蛋白的测定,将检测结果与病理结果进行对照。预先设定FNA-Tg/serunTg>1、10ng/ml、100ng/ml 3个阳性界值,分别计算其诊断的敏感性及特异性并进行对比。结果:46枚转移性淋巴结中甲状腺球蛋白浓度的中位值为5 251ng/ml(1.79~408 300ng/ml),11枚阴性淋巴结中甲状腺球蛋白浓度的中位值为0.68ng/ml(0.04~125.4ng/ml),3个阳性界值的诊断敏感性分别为91.30%、97.83%、93.48%,诊断的特异性分别为81.82%、63.64%、90.90%,诊断的准确性分别为89.47%、91.22%、92.98%。结论:淋巴结细针穿刺洗脱液中甲状腺球蛋白测定诊断分化型甲状腺癌淋巴结转移具有可行性。Objective：To investigate the feasibiity of detecting lymph node metastasis in differentiated thyroid cancer patients by thyroglobin（Tg）measurement in fine-needle aspiration washout fluid.Method：Forty-seven differentiated thyroid cancer patients with cervical lymph node metastasis were included in this study.Fine-needle aspirations were performed on lymph nodes which were surgically resected for measurement of Tg in washout fluid.Diagnostic sensitivity,specificity and accuracy were evaluated according to three predetermined Tg threshold values：FNA-Tg/serum Tg1,10 ng/ml and 100 ng/ml.Result：The meadian value of FNA-Tg in metastatic lymph node（n=46）was 5 177 ng/ml（1.79-408 300 ng/ml）,while lymph node without metastasis（n=11）showed a meadian level of 0.63 ng/ml（0.04-125.4 ng/ml）.With the threshold of FNA-Tg level at FNA-Tg/serum Tg1,10 ng/ml and 100 ng/ml respectively,the diagnostic sensitivity was 91.3%,97.83% and 93.48% respectively,the specificity was 81.82%,63.64% and 90.90% respectively,and the accuracy was 89.47%,91.22% and 92.98% respectively.Conclusion：Thyroglobin measurement in fine-needle aspiration washout fluid is effective to diagnose lymph node metastasis in differentiated thyroid cancer.

关 键 词：甲状腺肿瘤 甲状腺球蛋白 细针穿刺 淋巴结转移 

分 类 号：R736.1[医药卫生—肿瘤]