超声引导下淋巴结细针抽吸活组织细胞学检查联合抽吸洗脱液中甲状腺球蛋白检测对甲状腺乳头状癌颈部淋巴结转移的诊断价值  

Diagnostic value of ultrasound-guided fine-needle aspiration cytology and thyroglobulin detection in aspiration washout fluid for neck lymph nodes metastasis in patients with papillary thyroid carcinoma

作　　者：高海锋[1] 赵秋剑[1] 高自颖 马宁[2] Gao Haifeng;Zhao Qiujian;Gao Ziying;Ma Ning(Department of Clinical Laboratory,Baoji Central Hospital,Baoji 721008,China;Department of Pathology,Baoji Central Hospital,Baoji 721008,China)

机构地区：[1]陕西省宝鸡市中心医院检验科,721008 [2]陕西省宝鸡市中心医院病理科,721008

出　　处：《肿瘤研究与临床》2019年第10期675-678,共4页Cancer Research and Clinic

摘　　要：目的探讨超声引导下淋巴结细针抽吸活组织细胞学检查(FNAC)联合细针抽吸洗脱液中甲状腺球蛋白(FNA-Tg)检测对甲状腺乳头状癌(PTC)颈部淋巴结转移的诊断价值。方法收集2015年8月至2018年10月宝鸡市中心医院经病理活组织检查证实的PTC患者214例,行超声引导下淋巴结FNAC,同时采用电化学发光免疫法测定FNA-Tg,所有可疑淋巴结切除后行组织病理学检查,对所有检查结果进行统计学分析。结果214例PTC患者共检出可疑肿大淋巴结282个。经组织病理学检查证实淋巴结转移阳性220个,阴性62个。FNAC检出淋巴结转移阳性193个,阴性89个,该方法诊断PTC淋巴结转移的灵敏度、特异度、约登指数、阳性预测值、阴性预测值、准确度分别为84.55%、88.71%、73.26%、96.37%、61.80%、85.46%。FNA-Tg检出淋巴结转移阳性198个,阴性84个,该方法诊断PTC淋巴结转移的灵敏度、特异度、约登指数、阳性预测值、阴性预测值、准确度分别为88.64%、95.16%、83.80%、98.48%、70.24%、90.07%。两种方法联合检出PTC淋巴结转移阳性215个,阴性67个,联合诊断的灵敏度、特异度、约登指数、阳性预测值、阴性预测值、准确度分别为97.63%、87.32%、84.95%、95.81%、92.54%、96.81%。联合检测PTC淋巴结转移的灵敏度和准确度均较FNAC和FNA-Tg单独检测高,差异均有统计学意义(均P<0.05)。结论FNAC和FNA-Tg检测方法简便、安全、准确,二者联合检测可提高诊断PTC淋巴结转移的灵敏度和准确度。Objective To investigate the diagnostic value of ultrasound-guided fine-needle aspiration cytology(FNAC)and fine-needle aspiration washout fluid thyroglobulin(FNA-Tg)detection for neck lymph nodes metastasis in patients with papillary thyroid carcinoma(PTC).Methods A total of 214 PTC patients confirmed by pathology biopsy in Baoji Central Hospital from August 2015 to October 2018 were collected,and they all underwent ultrasound-guided FNAC,and FNA-Tg was measured by using electrochemiluminescence immunoassay.The histopathologic detection was performed for all suspicious lymph nodes after lymphadenectomy,and the results were analyzed by using statistics.Results There were 282 suspicious enlarged lymph nodes detected from 214 PTC patients.Histopathological examination showed 220 lymph node metastases were positive,62 were negative.FNAC examination showed 193 lymph nodes were positive and 89 were negative.The sensitivity,specificity,Youden index,positive predictive value,negative predictive value,accuracy of FNAC for diagnosing the lymph nodes of metastasis PTC was 84.55%,88.71%,73.26%,96.37%,61.80%,85.46%,respectively.FNA-Tg test showed that 198 lymph nodes were diagnosed as positive metastasis and 84 were negative metastasis.The sensitivity,specificity,Youden index,positive predictive value,negative predictive value,accuracy of FNA-Tg for diagnosing the lymph nodes of metastasis PTC was 88.64%,95.16%,83.80%,98.48%,70.24%,90.07%,respectively.Both FNAC and FNA-Tg test showed 215 lymph nodes were diagnosed as positive metastasis and 76 were negative metastasis.The sensitivity,specificity,Youden index,positive predictive value,negative predictive value,accuracy of combined treatments were 97.63%,87.32%,84.95%,95.81%,92.54%,96.81%,respectively.The sensitivity and accuracy of combined detection were higher than those of single detection,and there were statistically significant differences(all P<0.05).Conclusions FNAC and FNA-Tg detection are simple,safe and accurate.The combined detection of FNAC and FNA-Tg can improve

关 键 词：甲状腺肿瘤 癌 乳头状 淋巴结转移 活组织检查 细针 洗脱液 甲状腺球蛋白 

分 类 号：R73[医药卫生—肿瘤]