甲状腺髓样癌的超声特征分析及诊断价值  

Ultrasonic characteristics of medullary thyroid carcinoma and their diagnostic value

作　　者：钏志睿 杨红英[1] 罗晓茂[1] 李支尧[1] 陈东[1] 陈海涛[1] CHUAN Zhirui;YANG Hongying;LUO Xiaomao;LI Zhiyao;CHEN Dong;CHEN Haitao(Department of Ultrasound,The Third Affiliated Hospital of Kunming Medical University,Yunnan Cancer Hospital Yunnan,Kunming 650118,China)

机构地区：[1]昆明医科大学第三附属医院,云南省肿瘤医院超声医学科,昆明650118

出　　处：《临床与病理杂志》2021年第5期1075-1080,共6页Journal of Clinical and Pathological Research

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项基金(2019FE001-241,2018FE001-071)。

摘　　要：目的:探讨甲状腺髓样癌(medullary thyroid carcinoma,MTC)的超声影像特征及诊断价值。方法:回顾性分析2016年1月至2019年12月经昆明医科大学第三附属医院病理确诊的33例MTC患者共49个结节和100例甲状腺乳头状癌(papillary thyroid carcinoma,PTC)患者共108个结节,对比MTC与PTC的临床资料和超声影像特征,分析两者超声影像的差异。结果:两组的结节最大径、形状、边界、纵横比、钙化、血流分布(包括内部血流及周边血流)等超声影像特征、血清降钙素水平和癌胚抗原水平差异具有统计学意义(P<0.05)。此外,MTC组有17例(51.5%)发生颈部淋巴结转移,其中伴有外侧组颈部淋巴结转移14例(82.4%)。结论:MTC与PTC对比主要超声表现为结节体积大,边界清楚,形状规则,纵横比<1,有粗钙化,伴有囊性变,血供丰富且紊乱,周边可有环状血流信号,易出现外侧组淋巴结转移,结合血清降钙素与癌胚抗原检测将有助于提高MTC的诊断准确率。Objective:To investigate the ultrasonographic characteristics and their diagnostic value of medullary thyroid carcinoma(MTC).Methods:A total of 49 nodules in 33 patients with MTC and 108 nodules in 100 patients with papillary thyroid carcinoma(PTC)pathologically diagnosed in our hospital from January 2016 to December 2019 were retrospectively analyzed.The clinical data and ultrasound imaging characteristics of MTC and PTC were compared to analyze the differences in the manifestations of ultrasound imaging.Results:The differences between MTC group and PTC group were statistically significant in ultrasonographic features such as the maximum diameter,shape,boundary,aspect ratio,calcification and blood flow distribution(including internal and peripheral blood flow)and serum calcitonin and carcinoembryonic antigen levels(P<0.05).In addition,17 patients(51.5%)in the MTC group had cervical lymph node metastasis,among which 14 patients(82.4%)in the lateral group had cervical lymph node metastasis.Conclusion:Compared to PTC,primary ultrasound findings of MTC were as follows:nodules with large volume,clear boundary,regular shape,aspect ratio<1,containing coarse calcification,accompanied by cystic changes,abundant and disordered blood supply,peripheral annular blood flow signals,prone to lymph node metastasis in the lateral group.The combination of serum calcitonin and carcinoembryonic antigen detection is helpful to improve the diagnostic accuracy of MTC.

关 键 词：甲状腺髓样癌 超声影像特征 甲状腺乳头状癌 降钙素 癌胚抗原 

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