甲状腺转移癌超声征象及超声引导下细针穿刺术活组织检查的价值  

Ultrasonic Signs and Clinical Features of Thyroid Metastases,and the Diagnostic Value of Ultrasound-Guided Fine-Needle Aspiration Biopsy

作　　者：朱媛[1] 王珍芳[1] 商静 张雪梅[1] 张巍 刘波[1] 高燕华[1] Zhu Yuan;Wang Zhenfang;Shang Jing;Zhang Xuemei;Zhang Wei;Liu Bo;Gao Yanhua(Ultrasonic Diagnostic Center,Shaanxi Provincial People's Hospital,Xi'an 710068,China;Pathology Department,Shaanxi Provincial People's Hospital,Xi'an 710068,China)

机构地区：[1]陕西省人民医院超声诊断中心,西安市710068 [2]陕西省人民医院病理科,西安市710068

出　　处：《中国超声医学杂志》2024年第1期103-106,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 本研究旨在分析甲状腺转移癌的超声声像图特征及临床特点,探讨细针穿刺术活组织检查在甲状腺转移癌诊断中的作用。方法 回顾性分析收治的细胞学和/或病理学诊断为甲状腺转移癌的22例患者的临床资料,超声对肿瘤的位置、数量、大小、形态、内部回声、有无钙化、边界、血流和颈部淋巴结进行评估。同时收集肿瘤的细胞学或组织病理学(或两者)的结果。结果 22例患者中,男性11例,女性11例,男女比例为1∶1;原发肿瘤依次为食管癌6例、肺癌6例、咽癌4例、气管来源腺囊性癌3例、胃癌1例,不明来源癌2例;从诊断原发肿瘤到发现甲状腺转移癌,间隔0~130个月,中位时间为14.5个月。超声表现为18例(81.8%)结节型,4例(18.1%)弥漫型,22例患者中21例(95.5%)出现淋巴结转移。16例行超声内镜引导细针穿刺抽吸术(FNA)检查,11例细胞学正确诊断,3例未提示来源。结论 大多数甲状腺癌转移性的超声特征以结节型为主,发生淋巴结转移可能性大;对于某些具有非典型超声特征的病例,超声诊断应结合病史。FNA结合免疫组化及病史对诊断有帮助。Objective This study was aimed to analyze the ultrasonic and clinical features of thyroid metastasis and to explore the role of fine-needle aspiration(FNA)biopsy in the diagnosis of thyroid metastasis.Methods The clinical data of 22 patients with cytology and/or pathological diagnosis of thyroid metastases admitted Shaanxi Provincial People's Hospital were retrospectively analyzed.The location,number,size,internal echo,shape,boundary and relationship with surrounding tissues,blood flow and cervical lymph nodes were evaluated by ultrasound.Results from cytology or histopathology(or both)of the tumor were collected at the same time.Results Among the 22 patients,11 were males and 11 were females,with a male-to-female ratio of 1∶1.The primary tumors included 6 cases of esophageal cancer,6 of lung cancer,4 cases of pharyngeal cancer,3 cases of adenoid cystic carcinoma,1 of gastric cancer,and 2 of unknown origin.The median interval was 0~130 months from the time of diagnosiing the primary tumor to the time of detection of thyroid metastases,and the median time was 14.5 months.Ultrasound features showed nodular type in 18 cases(81.8%),diffuse type in 4 cases(18.1%),and lymph node metastases in 21 cases(95.5%).FNA was performed in 16 cases,among whom,11 were cytologically correct,and 3 cases did not indicate the source.Conclusions The ultrasound features of most metastatic thyroid cancers are similar to those of primary thyroid cancer.In the cases with atypical ultrasound features,ultrasound diagnosis should be made in conjunction with medical history.FNA combined with immunohistochemistry and history is helpful for diagnosis.

关 键 词：甲状腺 甲状腺转移癌 FNA 

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]