甲状腺微小乳头状癌的彩色多普勒超声特征与颈部淋巴结转移的关系  

Color Doppler ultrasonographic features of papillary thyroid microcarcinoma and its relationship with cervical lymph node metastasis

作　　者：谈啸 陆军 TAN Xiao;LU Jun(Department of Ultrasound,the Affiliated Huaian First Hospital of Nanjing Medical University,Huaian 223300,Jiangsu,China)

机构地区：[1]南京医科大学附属淮安第一医院超声科

出　　处：《癌症进展》2019年第23期2815-2818,共4页Oncology Progress

摘　　要：目的探讨甲状腺微小乳头状癌(PTMC)的彩色多普勒超声特征与颈部淋巴结转移的关系。方法根据术后是否发生颈部淋巴结转移将78例PTMC患者分为转移组和非转移组,所有患者术前均进行了彩色多普勒超声检查,观察患者的彩色多普勒超声图像特征,并以术后病理学检查结果为金标准,分析术前彩色多普勒超声检查对PTMC患者术后发生颈部淋巴结转移的诊断效能。结果术后病理学检查结果显示,78例PTMC患者中,发生颈部淋巴结转移患者27例(转移组),未发生颈部淋巴结转移患者51例(非转移组)。彩色多普勒超声检查结果显示,78例PTMC患者中,发生颈部淋巴结转移患者20例,未发生颈部淋巴结转移患者58例。转移组PTMC患者的甲状腺结节数量为41个,非转移组PTMC患者的甲状腺结节数量为83个。两组PTMC患者的甲状腺结节最大径、甲状腺结节与包膜的接触面积、肿瘤边界、病灶数量和血流分布情况比较,差异均有统计学意义(P﹤0.05);两组患者的肿瘤形态、肿瘤边缘、纵横比、合并桥本甲状腺炎情况、声晕和回声水平比较,差异均无统计学意义(P﹥0.05)。彩色多普勒超声诊断PTMC患者术后发生颈部淋巴结转移的灵敏度为59.26%,特异度为92.16%,阳性预测值为80.00%,阴性预测值为81.03%。结论PTMC彩色多普勒超声特征能够在甲状腺结节最大径、甲状腺结节与包膜的接触面积、肿瘤边界、病灶数量、血流分布情况方面反映PTMC患者术后的颈部淋巴结转移情况,能够为临床制订PTMC术中淋巴清扫方案提供参考依据。Objective To investigate the color Doppler ultrasonographic features of papillary thyroid microcarcinoma(PTMC)and the relationship with occurrence of cervical lymph node metastasis.Method Seventy-eight patients with PTMC were included in the study as metastasis group and non-metastasis group based on whether they had cervical lymph node metastasisor not.All patients underwent color Doppler ultrasonography examination before surgery to observe the features of color Doppler ultrasound images.Besides,with postoperative pathological examination as the gold standard,the diagnostic efficacy of preoperative color Doppler ultrasonography for cervical lymph node metastasis in PTMC patients was analyzed.Result Postoperative pathological examination showed that among the 78 cases with PTMC,27 patients had cervical lymph node metastasis(metastasis group)and 51 patients had not(non-metastasis group).Color Doppler ultrasonography examination showed that among the 78 cases with PTMC,20 cases with cervical lymph node metastasis and 58 cases without cervical lymph node metastasis.The number of thyroid nodules in PTMC patients in the metastasis group was 41,and the number of thyroid nodules in PTMC patients in the non-metastatic group was 83.The maximum diameter of thyroid nodules,the area of contact between thyroid nodules and capsule,tumor boundary,number of lesions and blood flow distribution in PTMC patients in metastasis group and non-metastasis group differed significantly(P<0.05).Similar results were noted in regard to the tumor morphology,tumor margin,anteroposterior and transverse diameter ratio,comorbid Hashimoto’s thyroiditis,acoustic halo and echo levels between the two groups(P>0.05).Referring to postoperative pathological findings,preoperative color Doppler ultrasonographyrepresented the sensitivity of 59.26%,specificity of 92.16%,positive predictive value of 80.00%,and negative predictive value of 81.03%in the diagnosis of cervical lymph node metastasis among patients with PTMC.Conclusion Color Doppler ultrasonogr

关 键 词：甲状腺微小乳头状癌 彩色多普勒超声 颈部淋巴结 转移 结节 

分 类 号：R737.9[医药卫生—肿瘤]