超声在甲状腺乳头状癌中央区淋巴结转移中的诊断价值  

Diagnostic value of ultrasonography in central lymph node metastasis of papillary thyroid carcinoma

作　　者：陈欣欣 梁雁 陈铃[1] 刘晓琳 刘桂连[1] 林鸿国 CHEN Xinxin;LIANG Yan;CHEN Ling;LIU Xiaolin;LIU Guilian;LIN Hongguo(Department of Ultrasonic,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine Guangdong Provincial Hospital of Chinese Medicine,Guangdong Province,Guangzhou 510120,China;Department of Thyroid Surgery,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine Guangdong Provincial Hospital of Chinese Medicine,Guangdong Province,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二临床医院广东省中医院超声科,广东广州510120 [2]广州中医药大学第二临床医学院广东省中医院甲状腺外科,广东广州510120

出　　处：《中国医药导报》2023年第7期157-160,共4页China Medical Herald

基　　金：广东省科技计划项目(2017ZC0162)。

摘　　要：目的探讨超声对甲状腺乳头状癌(PTC)颈部中央区淋巴结转移(CLNM)的诊断价值。方法回顾性分析2018年11月至2019年7月于广东省中医院行甲状腺癌手术且病理证实为PTC的113例患者。观察病灶最大径、形态、边缘、纵横比、内部回声、钙化、后方回声、包膜侵犯、血流信号等超声特征;分析超声在PTC患者CLNM中的诊断价值。结果113例PTC患者术前超声提示CLNM 37例,病理结果显示CLNM 52例。术前超声诊断PTC患者CLNM的灵敏度、特异度、准确率、阳性预测值和阴性预测值分别为61.5%、91.8%、77.9%、86.5%和73.7%。有无CLNM患者结节最大径、微钙化、包膜侵犯比较,差异有统计学意义(P<0.05)。结论PTC结节最大径≥1.5 cm、包膜侵犯、微钙化的患者易发生颈部CLNM,术前应重视和规范颈部淋巴结的扫查和评估。Objective To explore the diagnostic value of ultrasonography in central lymph node metastasis(CLNM)of papillary thyroid carcinoma(PTC).Methods A retrospective analysis was performed on 113 patients with PTC confirmed by pathology who underwent thyroid cancer surgery in Guangdong Provincial Hospital of Chinese Medicine from November 2018 to July 2019.The maximum diameter,shape,edge,aspect ratio,internal echo,calcification,posterior echo,capsule invasion,blood flow signal,and other ultrasonic characteristics were observed;the diagnostic value of ultrasound in CLNM of PTC patients was analyzed.Results Among 113 patients with PTC,preoperative ultrasound showed CLNM in 37 cases,and pathological results showed CLNM in 52 cases.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of preoperative ultrasonic diagnosis of CLNM in PTC patients were 61.5%,91.8%,77.9%,86.5%,and 73.7%,respectively.There were statistically significant differences in maximum nodule diameter,microcalcification,and capsule invasion in patients with or without CLNM(P<0.05).Conclusion For patients with maximum diameter of PTC nodule≥1.5 cm,capsule invasion,and microcalcification,cervical CLNM is prone to occur,and preoperative examination and evaluation of cervical lymph nodes should be paid attention to and standardized.

关 键 词：甲状腺乳头状癌 超声 中央区淋巴结 转移 

分 类 号：R736.1[医药卫生—肿瘤]