细针穿刺洗脱液测定甲状腺球蛋白和细针穿刺细胞学诊断甲状腺乳头状癌颈部淋巴结转移的Meta分析  

Fine-needle aspiration washout fluid for measuring thyroglobulin and fine-needle aspiration cytology in the diagnosis of cervical lymph node metastasis in papillary thyroid carcinoma:a Meta-analysis

作　　者：杨汶士[1] 张艳[1] 张凤凤[1] 王思雷 Yang Wenshi;Zhang Yan;Zhang Fengfeng;Wang Silei(Department of Breast and Thyroid Surgery,the Central People's Hospital of Tengzhou,Tengzhou 277500,China)

机构地区：[1]滕州市中心人民医院乳腺甲状腺外科,滕州277500

出　　处：《肿瘤研究与临床》2022年第2期137-141,共5页Cancer Research and Clinic

摘　　要：目的:系统评价细针穿刺洗脱液测定甲状腺球蛋白(FNA-Tg)和细针穿刺细胞学(FNAC)对甲状腺乳头状癌颈部淋巴结转移的诊断价值。方法:检索中国期刊全文数据库、万方数据库、维普中文科技期刊数据库等数据库中2016年1月至2020年12月以病理组织诊断为金标准对比分析FNA-Tg和FNAC诊断甲状腺乳头状癌颈部淋巴结转移的诊断试验。根据Cochrane协作网筛选与诊断试验方法组推荐的诊断试验纳入标准筛选文献,对纳入文献进行质量评价和特征信息提取。应用Review Manager 5.0、MetaDiSc软件进行Meta分析,并绘制两种方法诊断淋巴结转移的汇总受试者工作特征(SROC)曲线,获得曲线下面积,判断诊断效能。结果:共纳入19篇文献,涉及2 792枚颈部淋巴结。FNAC和FNA-Tg诊断甲状腺乳头状癌颈部淋巴结转移的灵敏度分别为0.80(95% CI 0.78~0.81)和0.92(95% CI 0.91~0.93),特异度分别为0.93(95% CI 0.92~0.95)和0.91(95% CI 0.89~0.93),诊断比值比分别为51.55(95% CI 38.61~68.81)和110.03(95% CI 82.18~147.32),SROC曲线下面积分别为0.900和0.968。 结论:FNA-Tg对甲状腺乳头状癌颈部淋巴结转移诊断的准确性高于FNAC,FNA-Tg是FNAC诊断的一个重要补充,建议广泛应用于临床。Objective To systematically evaluate the diagnostic value of fine-needle aspiration washout fluid for measuring thyroglobulin(FNA-Tg)and fine-needle aspiration cytology(FNAC)in cervical lymph node metastasis of papillary thyroid carcinoma.Methods Chinese Journal Full-Text Database,Wanfang Database,VIP Chinese Science and Technology Journal Database and other databases from January 2016 to December 2020 were retrieved.And then diagnostic trials from the databases regarding the comparison of FNA-Tg and FNAC in the diagnosis of papillary thyroid carcinoma with neck lymph node metastasis based on the histopathological diagnosis as the gold standard were included.The literatures were screened out according to the diagnostic test inclusion criteria recommended by the Cochrane Collaboration Screening and Diagnostic Test Methods Group;and then the quality of the included literatures was evaluated and feature information was extracted.Review Manager 5.0 and MetaDiSc software were used to conduct Meta analysis,and a summary receiver operating characteristic(SROC)curve of FNAC and FNA-Tg in the diagnosis of lymph node metastasis was drawn to calculate the area under the curve and to judge the diagnostic efficacy.Results A total of 19 articles and 2792 cervical lymph nodes were finally included.The sensitivity of FNAC and FNA-Tg in the diagnosis of cervical lymph node metastasis in papillary thyroid carcinoma was 0.80(95%CI 0.78-0.81)and 0.92(95%CI 0.91-0.93),respectively;the specificity was 0.93(95%CI 0.92-0.95)and 0.91(95%CI 0.89-0.93);the diagnostic odds ratio was 51.55(95%CI 38.61-68.81)and 110.03(95%CI 82.18-147.32),respectively;the areas under the SROC curve was 0.900 and 0.968,respectively.Conclusions The accuracy of FNA-Tg in the diagnosis of cervical lymph node metastasis of papillary thyroid carcinoma is higher than that of FNAC.FNA-Tg can be used as an important diagnosis supplement to FNAC and it can be widely used in clinical practice.

关 键 词：甲状腺肿瘤 癌 乳头状 淋巴转移 活组织检查 细针 

分 类 号：R736.1[医药卫生—肿瘤]