多灶性甲状腺乳头状癌的超声及病理特征分析  

Analysis of ultrasonographic and pathological features of multifocal papillary thyroid carcinoma

作　　者：徐丽华[1] 赵鸿飞 张楠[2] 类婷婷 韩彤亮[1] XU Lihua;ZHAO Hongfei;ZHANG Nang;LEI Tingting;HAN Tongliang(Department of Ultrasonography,Qingdao Municipal Hospital Affiliated to Qingdao University,Qingdao 266000,P.R.China;Department of Ultrasonography,Qingdao Women and Children's Hospital Affiliated to Qingdao University,Qingdao 266000,P.R.China)

机构地区：[1]青岛大学附属青岛市市立医院超声科,山东青岛266000 [2]青岛大学附属青岛市妇女儿童医院超声科,山东青岛266000

出　　处：《医学影像学杂志》2020年第9期1578-1581,共4页Journal of Medical Imaging

基　　金：山东省青岛市卫生和计划生育委员会医药科研指导计划项目(编号:2018-WJZD003)。

摘　　要：目的探讨超声在诊断分析多灶性甲状腺乳头状癌(MPTC)特征中的价值。方法回顾性分析经病理证实的86例MPTC患者的术前超声检查声像图特征,按照微小癌及非微小癌、是否存在颈部淋巴结转移进行分组,比较两组病例的超声及临床病理特征。结果86例MPTC患者共发现病灶210枚,术前超声检出甲状腺癌175枚,漏诊6枚,病理为直径0.2cm的微灶,误诊为结节性甲状腺肿29枚,超声诊断符合率83.3%(175/210)。病灶位于单侧26例,双侧60例。非微小癌50例,微小癌36例。16例(18.6%,16/86)合并桥本甲状腺炎,31例(36%,31/86)合并结节性甲状腺肿。颈部淋巴结肿大36例,31例出现转移灶。非微小癌组与微小癌组两者在血流分布及淋巴结转移方面差异有统计学意义(均P<0.05)。与颈部无淋巴结转移组比较,淋巴结有转移组病灶个数有统计学差异(P<0.05)。结论高频超声有助于多灶性甲状腺乳头状癌的诊断,对于微小癌,当合并多发良性结节及桥本甲状腺炎病变时,应注意综合分析,避免漏误诊。同时,应仔细观察颈部淋巴结情况,为临床诊断、治疗提供重要信息。Objective To investigate the ultrasonographic factors of multifocal papillary thyroid carcinoma(MPTC).Methods We collected and retrospectively analyzed the ultrasonographic factors of 86 patients who were diagnosed as multifocal papillary thyroid carcinoma by pathology.According to size of the lesion and the presence of lymph node metastasis,they were divided into two different groups.Summary analysis of ultrasonic and clincal features were made between the two groups.Results 210 lesions in 86 cases were found totally,all of them were confirmed as papillary thyroid carcinoma(PTC).175 nodules of thyroid cancers were detected by ultrasound before surgery,and 6 lessions were missed diagnosis,which were confirmed by pathology as thyroid microcarcinoma with a diameter of 0.2 cm.A total of 29 nodules were misdiagnosed as thyroid nodular goiter.The coincidence rate of ultrasound diagnosis was 83.3%(175/210).The lesions were located in 26 cases of thyroid on one side and 60 cases on both sides.There were single microcarcinoma in 36 cases and combined microcarcinoma in 50 cases.16 cases(18.6%,16/86)coexisted with Hashimoto’s thyroiditis,31 cases(36%,31/86)accompanied thyroid nodular goiters.Lymph node metastasis occurred in 31 cases.Conclusion High frequency ultrasound could be useful in diagnosis of MPTCs.When MPTCs associated with either multifocal benign nodules or Hashimoto’s thyroiditis,especially for the microcarcinomas,more attention should be paid.

关 键 词：甲状腺肿瘤 乳头状癌 多灶性 超声检查 

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