高频超声联合血清降钙素、癌胚抗原对甲状腺髓样癌的诊断价值  

High-frequency ultrasonography combined with serum calcitonin and carcinoembryonic antigen level in the diagnosis of medul-lary thyroid carcinoma

作　　者：任玉娟 曹子洋[1] 史晓兰 张秋月 REN Yujuan;CAO Ziyang;SHI Xiaolan;ZHANG Qiuyue(Department of Ultrasonography,Liaocheng Second People's Hospital,Liaocheng 252600,China;不详)

机构地区：[1]聊城市第二人民医院超声科,252600 [2]聊城市第二人民医院病理科,252600 [3]聊城市第二人民医院检验科,252600

出　　处：《浙江医学》2024年第17期1861-1864,1871,共5页Zhejiang Medical Journal

摘　　要：目的探讨高频超声联合血清降钙素(CT)、癌胚抗原(CEA)检查在甲状腺髓样癌(MTC)诊断中的价值。方法回顾性选取2015年1月至2023年2月在聊城市第二人民医院经术后病理证实的MTC患者55例为研究对象(MTC组),另选取同期在本院经术后病理证实的甲状腺良性肿瘤患者77例为对照(非MTC组)。所有患者术前均行高频超声及血清CT、CEA检查。比较两组患者的超声声像图特征。以术后病理诊断结果为金标准,比较高频超声、血清学检查及联合检查对MTC的诊断效能。结果MTC组与非MTC组高频超声声像图,在纵横比、位置方面比较差异均无统计学意义(均P>0.05),但在成分、回声、边缘、钙化方面比较差异均有统计学意义(均P<0.05)。高频超声诊断MTC的灵敏度、特异度和准确率分别为63.64%、70.13%、67.42%,血清学检查分别为70.91%、72.73%、71.97%,联合检查分别为87.27%、88.31%、87.88%。联合检查的灵敏度、特异度和准确率均高于高频超声检查和血清学检查(均P<0.05)。结论与甲状腺良性肿瘤相比,MTC很少发生囊性变,其超声声像图更易表现为实性、低回声、边缘欠光整、合并粗大钙化。高频超声联合血清CT、CEA检查能明显提高MTC的诊断准确率,可弥补单一检查的不足,能指导临床选择更精准的手术方案。Objective To explore the value of high-frequency ultrasonography combined with serum calcitonin(CT)and carcinoembryonic antigen(CEA)examination in the diagnosis of medullary thyroid carcinoma(MTC).Methods Fifty-five patients with MTC confirmed by postoperative pathology in Liaocheng Second People's Hospital from January 2015 to February 2023 were enrolled as MTC group,while another 77 patients confirmed with benign thyroid tumors by postoperative pathology and treated in the same period were selected as non-MTC group.All patients underwent high-frequency ultrasonograpy before surgery,and serum CT and CEA were also examined.The sonographic characteristics and serum CT and CEA levels were compared between the two groups.The values of high-frequency ultrasonography,and serum examination used alone or in combination for diagnosing MTC were assessed,with the postoperative pathological diagnosis as the gold standard.Results There were no significant differences in anteroposterior/transverse diameter ratio and position of the high-frequency ultrasonic image between the MTC group and the non-MTC group(both P>0.05),but significant differences were observed in composition,echo,margin,and calcification between the two groups(all P<0.05).The sensitivity,specificity and accuracy in the diagnosis of MTC were 63.64%,70.13%and 67.42%respectively by high frequency ultrasound,70.91%,72.73%and 71.97%respectively by serum CT and CEA levels,and 87.27%,88.31%and 87.88%respectively by combined examination.The sensitivity,specificity and accuracy of combined examination were all higher than those of high-frequency ultrasonography and serum examination(all P<0.05).Conclusion Compared with benign thyroid tumors,MTC rarely has cystic changes,and its ultrasound images are more likely to be solid,hypoechoic,unsmooth margin,and combined with coarse calcification.The combination of high-frequency ultrasonography,and serum CT and CEA examination can significantly improve the diagnosis performance for MTC,compared with ultrasonography and serum

关 键 词：高频超声 降钙素 癌胚抗原 联合检查 甲状腺髓样癌 

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]