甲状腺滤泡癌与腺瘤的超声声像比较研究  

Comparative study of ultrasound imaging of thyroid follicular carcinoma and adenoma

作　　者：谢文婷[1] 陈轶洁[1] 黄伟钦[1] 杜忠实[1] 唐丽娜[1] XIE Wenting;CHEN Yijie;HUANG Weiqin;DU Zhongshi;TANG Lina(Department of Ultrasound,Fujian Cancer Hospital&Fujian Medical University Cancer Hospital,Fuzhou 350014,Fujian Province,China)

机构地区：[1]福建省肿瘤医院/福建医科大学附属肿瘤医院超声科,福建福州350014

出　　处：《肿瘤》2020年第5期348-354,共7页Tumor

基　　金：福建省科技创新联合资金项目(编号:2017Y0021)。

摘　　要：目的 :探讨超声声像特征在鉴别诊断甲状腺滤泡癌与甲状腺瘤中的应用价值。方法 :回顾性分析甲状腺滤泡癌和腺瘤患者的超声诊断及临床资料。采用t检验及单因素分析法对各项参数进行分析,将有统计学意义的参数进一步纳入多因素分析。结果 :甲状腺滤泡癌与腺瘤在边界、形态、"结中结"和"小梁形成"方面具有明显差异(P值均<0.05)。24.1%的滤泡癌出现边界不清,而腺瘤大部分表现为边界清晰。50.6%的滤泡癌表现为形态不规则,而83.0%的腺瘤以形态规则为主。19.5%的滤泡癌存在"结中结",而仅有5.7%的腺瘤存在"结中结"。49.4%的滤泡癌存在"小梁形成",而腺瘤具有"小梁形成"的占比为20.8%。多因素分析表明,"小梁形成"在滤泡癌与腺瘤的鉴别诊断中具有统计学意义(P <0.05)。结论 :超声声像中发现"小梁形成"有助于判断为甲状腺滤泡癌。Objective:To explore the value of ultrasound features in differentiating follicular thyroid carcinoma and thyroid adenoma.Methods: The ultrasound and clinical data of thyroid follicular carcinoma and adenoma were retrospectively analyzed.Each parameter was analyzed by Student’s t-test and monofactor analysis. The parameters with statistical significance were further analyzed by multivariate analysis.Results: There were statistical differences between follicular carcinoma and adenoma in borders, morphology, "tubercle-in-nodule", and "trabecular formation". In 24.1% of follicular cancers, the boundary of nodule was unclear;while most of the adenomas showed clear boundaries. In 50.6% of follicular cancers, the nodule morphology was irregular;while 83.0% of adenomas showed regular morphology. In 19.5% of follicular cancers, "tubercle-in-nodule" feature was showed;while only 5.7% of adenomas had "tubercle-in-nodule" feature. In 49.4% of follicular cancers, "trabecular formation" was found;while the proportion of adenomas with "trabecular formation" was 20.8%. Multivariate analysis showed that "trabecular formation" was statistically significant in the distinction between follicular carcinoma and adenoma.Conclusion: Trabecular formation as an ultrasound feature is helpful for the ultrasound diagnosis of follicular thyroid carcinoma.

关 键 词：甲状腺肿瘤 甲状腺结节 超声检查 诊断 鉴别 

分 类 号：R736.1[医药卫生—肿瘤]