甲状腺乳头状癌患者颈部淋巴结转移的超声诊断价值  

Ultrasound diagnostic value of cervical lymph node metastasis in patients with papillary thyroid carcinoma

作　　者：邵静[1] 郭秋香[1] 张佐炳[1] Shao Jing;Guo Qiuxiang;Zhang Zuobing(Department of Ultrasound,the First Affiliated Hospital of Xiamen University,Fujian 361000,China)

机构地区：[1]厦门大学附属第一医院超声科,361000

出　　处：《实用医学影像杂志》2023年第2期94-96,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨超声检查对甲状腺乳头状癌患者颈部淋巴结转移的诊断价值。方法回顾性分析经手术病理证实为乳头状癌的294例患者共322个结节,将322个结节分为转移组和无转移组,对2组间性别、年龄、结节位置、是否邻近包膜、结节大小进行统计学分析,年龄分为≤40岁和>40岁组,结节位置分为上部、中部、下部、峡部组,邻近包膜为在二维超声上紧贴包膜而未突破包膜,结节大小分为≤5 mm、5~10 mm、>10 mm组。并计算超声检查颈部淋巴结转移的灵敏度、特异度、漏诊率及误诊率。结果甲状腺乳头状癌患者颈部淋巴结转移与性别、结节位置及是否临近被膜差异无统计学意义(P>0.05),与患者年龄及结节大小差异有统计学意义(P<0.05)。患者的年龄和结节大小是颈部淋巴结转移的独立危险因素,年龄≤40岁(OR=0.57,P=0.020),结节大小5~<10 mm(OR=3.99,P=0.002),结节大小≥10 mm(OR=8.02,P<0.001)。超声诊断颈部转移性淋巴结的灵敏度为33.8%,特异度为96.8%,漏诊率为66.2%,误诊率为3.2%。结论超声检查对甲状腺乳头状癌患者颈部淋巴结转移有较高的诊断价值,但对中央区淋巴结术前诊断价值有限。Objective To explore the diagnostic value of ultrasonography for cervical lymph node metastasis in patients with papillary thyroid carcinoma.Methods A retrospective analysis of 294 patients with surgical pathologically confirmed papillary carcinoma with a total of 322 nodules was performed and 322 nodules were divided into metastatic and non-metastasis groups.The sex,age,nodule location,proximity to the capsule and nodule size were statistically analyzed,and the age was divided into≤40 years old and>40 years old group,the nodule position was divided into upper,middle,lower and isthmus groups,the adjacent capsule was close to the capsule on two-dimensional ultrasound without breaking through the capsule,and the nodule size was divided into≤5 mm,5~10 mm,>10 mm group.The sensitivity,specificity,missed diagnosis rate and misdiagnosis rate of cervical lymph node metastasis on ultrasound were calculated.Results There was no difference between cervical lymph node metastasis and sex,nodule location and proximity to the envelope in patients with papillary thyroid carcinoma(P>0.05),and there was a significant difference between cervical lymph node metastasis and the age and size of the patients(P<0.05).The age and nodule size of patients were independent risk factors for cervical lymph node metastasis,age≤40 years(OR=0.57,P=0.020),nodule size 5~<10 mm(OR=3.99,P=0.002),nodule size≥10 mm(OR=8.02,P<0.001).Ultrasound diagnostic of cervical metastatic lymph nodes with a sensitivity of 33.8%,specificity of 96.8%,missed rate of 66.2%,and misdiagnosis rate of 3.2%.Conclusion Ultrasonography has high diagnostic value for cervical lymph node metastasis in patients with papillary thyroid carcinoma but has limited value for preoperative diagnosis of central lymph nodes.

关 键 词：超声检查 甲状腺癌 乳头状 淋巴结 颈部 

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