超声引导下颈部淋巴结细针穿刺对甲状腺癌^(131)I治疗后复发的诊断价值  

Value of ultrasound-guided fine needle aspiration of cervical lymph nodes in the diagnosis of recurrence of thyroid cancer after^(131)I treatment

作　　者：王晶[1] 刘易婷 刘哲[3] WANG Jing;LIU Yiting;LIU Zhe(Department of Endocrinology and Metabolism,Yan’an University Affiliated Hospital,Yan’an 716000,Shaanxi,China;Ward 2,Department of Oncology,Yan’an University Affiliated Hospital,Yan’an 716000,Shaanxi,China;Department of Cardiology,Yan’an University Affiliated Hospital,Yan’an 716000,Shaanxi,China)

机构地区：[1]延安大学附属医院内分泌代谢科,陕西延安7160000 [2]延安大学附属医院肿瘤科二病区,陕西延安7160000 [3]延安大学附属医院心血管内科,陕西延安7160000

出　　处：《癌症进展》2022年第3期249-251,273,共4页Oncology Progress

摘　　要：目的分析超声引导下颈部淋巴结细针穿刺对甲状腺癌^(131)I治疗后复发的诊断价值。方法收集186例行甲状腺癌^(131)I治疗后经超声检查疑似复发患者的临床资料,患者均进行病理检查及超声引导下颈部淋巴结细针穿刺检查。以患者病理检查结果为金标准,对比复发与未复发患者超声征象,分析超声引导下颈部淋巴结细针穿刺对甲状腺癌^(131)I治疗后复发的诊断效能。结果186例疑似复发患者经病理检查证实复发159例,未复发27例。超声检查检出复发138例,细针穿刺检查检出复发153例。复发甲状腺癌患者超声表现中回声不均匀、钙化、血流信号2~3级、短轴与长轴之比≥1所占比例均明显高于未复发患者,差异均有统计学意义(P﹤0.01)。超声检查诊断甲状腺癌^(131)I治疗后复发的灵敏度为86.79%(138/159),特异度为37.04%(10/27),阳性预测值为89.03%(138/155),阴性预测值为32.26%(10/31);超声引导下颈部淋巴结细针穿刺诊断甲状腺癌^(131)I治疗后复发的灵敏度为96.23%(153/159),特异度为74.07%(20/27),阳性预测值为95.62%(153/160),阴性预测值为76.92%(20/26)。结论超声引导下颈部淋巴结细针穿刺在甲状腺癌^(131)I治疗后复发诊断中具有较高的应用价值,可为临床制订决策、治疗方案等提供参考资料。Objective To analyze the value of ultrasound-guided fine needle aspiration of cervical lymph nodes in the diagnosis of recurrence of thyroid cancer after^(131)I treatment.Method The clinical data of 186 patients with suspected recurrence of thyroid cancer after^(131)I treatment were collected through ultrasound examination.All patients underwent pathological examination and ultrasound-guided fine needle aspiration of cervical lymph nodes detection.Based on the results of the patient’s pathological examination,the ultrasound signs of patients with and without recurrence were compared,and the diagnostic efficacy of ultrasound-guided fine needle aspiration of cervical lymph nodes in the diagnosis of recurrence of thyroid cancer after^(131)I treatment was analyzed.Result A total of 186 cases of suspected recurrence were confirmed by pathological examination,159 cases with recurrence,and 27 cases without recurrence.138 cases were detected by ultrasound and 153 cases were detected by fine needle aspiration.The proportions of relapsed patients with uneven echo,calcification,blood flow signal level 2-3,and the ratio of short axis to long axis≥1 were significantly higher than that of non-recurring patients,the differences between the groups were statistically significant(P<0.01).The sensitivity,specificity,positive predictive value and negative predictive value of ultrasound for thyroid cancer recurrence after^(131)I treatment were 86.79%(138/159),37.04%(10/27),89.03%(138/155)and 32.26%(10/31),respectively.The sensitivity,specificity,positive predictive value and negative predictive value of ultrasound-guided fine needle aspiration of cervical lymph nodes were 96.23%(153/159),74.07%(20/27),95.62%(153/160)and 76.92%(20/26),respectively.Conclusion Ultrasound-guided fine needle aspiration of cervical lymph nodes has a high value in the diagnosis of recurrence of thyroid cancer after^(131)I treatment,and can provide reference materials for clinical decision-making and treatment options.

关 键 词：超声引导下颈部淋巴结细针穿刺 甲状腺癌 ^(131)I治疗 复发 诊断价值 

分 类 号：R736.1[医药卫生—肿瘤]