甲状腺微小乳头状癌中央区淋巴结转移的超声与病理对照  

Ultrasonographic and Pathological Comparison of Central Lymph Node Metastasis in Papillary Thyroid Microcarcinoma

作　　者：谭雯 肖伶俐 张诗文 郑昊鸣 杨安奎[3] 刘隆忠[1] Tan Wen;Xiao Lingli;Zhang Shiwen;Zheng Haoming;Yang Ankui;Liu Longzhong(Department of Ultrasound,Sun Yat-sen University Cancer Center,Guangzhou 510060,China;Department of Pathology,Sun Yat-sen University Cancer Center,Guangzhou 510060,China;Department of Head and Neck,Sun Yat-sen University Cancer Center,Guangzhou 510060,China)

机构地区：[1]中山大学肿瘤防治中心超声科,广州市510060 [2]中山大学肿瘤防治中心病理科,广州市510060 [3]中山大学肿瘤防治中心头颈科,广州市510060

出　　处：《中国超声医学杂志》2022年第12期1325-1327,共3页Chinese Journal of Ultrasound in Medicine

基　　金：广东省自然科学基金资助(No.2021A1515010546)。

摘　　要：目的 探究超声对甲状腺微小乳头状癌(PTMC)中央区宏转移淋巴结的诊断价值及影响超声诊断效能的因素。方法 纳入中山大学肿瘤防治中心行手术治疗的363例PTMC患者,将病理切片重新读片,以癌灶长径2 mm为界诊断宏转移与微转移。结果 中央区无、微、宏转移的比例为54%、28%、18%,宏转移组的侧颈转移率最高。3组超声探及率为46%、44%、73%。在微、宏转移区中,因超声未探及淋巴结而引起的假阴性约75%和88%。变圆、微钙化、局灶高回声是淋巴结宏转移的独立危险因素。结论 (1)超声对中央区宏转移淋巴结的诊断效能约0.7,微钙化和局灶高回声是提示中央区宏转移的重要图像特征。(2)超声对中央区淋巴结探及率低是影响其诊断效能的主要原因。Objective To investigate the diagnostic value of ultrasound in macro-metastatic central lymph nodes of Papillary Thyroid Microcarcinoma(PTMC), and to explore the factors affecting the diagnostic efficiency of ultrasound.Methods A total of 363 PTMC patients who underwent surgical treatment in Sun Yat-Sen University Cancer Center were enrolled in the study. The pathological sections were re-read, the macro-and micro-metastases were diagnosed by the 2 mm diameter of the tumor foci. Results The proportions of no-, micro-and macro-metastasis were 54%, 28% and 18%, and the lateral metastasis rate of macro-metastasis group was the highest. The ultrasonic detection rates of the three groups were 46%, 44% and 73%. In the micro-and macro-metastatic areas, the false negatives caused by the failure of lymph node detection by ultrasound accounted for 75% and 88%. Round shape, microcalcification and focal hyperechogenicity are independent risk factors for lymph node macro-metastasis. Conclusions(1)The diagnostic efficiency of ultrasonography for macro-metastatic central lymph nodes is about 0.7. Microcalcification and hyperechogenicity are important image features suggesting macro-metastasis.(2)The low detection rate of ultrasound for central lymph nodes is the main reason affecting its diagnostic efficiency.

关 键 词：甲状腺癌 中央区淋巴结 宏转移 超声 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]