术前超声引导FNA联合FNA-Tg测定诊断PTC颈部淋巴结转移的价值  

Value of preoperative ultrasound-guided fine-needle aspiration of lymph nodes combined with washout thyroglobulin testing in diagnosing lymph node metastasis in papillary thyroid carcinoma

作　　者：申学舟 陈利民 贺军 柳刚 项延包 黄晓萍 Shen Xuezhou;Chen Limin;He Jun;Liu Gang;Xiang Yanbao;Huang Xiaoping(Department of Ultrasound,Wenzhou Central Hospital,Wenzhou 325000,Zhejiang Province,China;Clinical Laboratory,Wenzhou Central Hospital,Wenzhou 325000,Zhejiang Province,China;Department of Pathology,Wenzhou Central Hospital,Wenzhou 325000,Zhejiang Province,China)

机构地区：[1]温州市中心医院超声影像科,温州325000 [2]温州市中心医院检验科,温州325000 [3]温州市中心医院病理科,温州325000

出　　处：《中国基层医药》2025年第3期342-346,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的评价术前淋巴结细针穿刺(FNA)联合穿刺洗脱液甲状腺球蛋白(FNA-Tg)检测在甲状腺乳头状癌(PTC)颈部淋巴结转移的诊断价值。方法选取2021年12月至2023年12月在温州市中心医院确诊患PTC且术前超声发现可疑侧颈部淋巴结转移的112例患者进行前瞻性研究,所有患者均接受淋巴结FNA和FNA-Tg,所有可疑淋巴结被手术摘除,对比分析FNA、FNA-Tg及FNA+FNA-Tg诊断PTC伴淋巴结转移的效能。结果112例患者检出120个淋巴结,其中98例淋巴结被病理证实发生转移。FNA细胞学检查结果83例为阳性,37例为阴性;侧颈部淋巴结转移诊断的准确度、灵敏度和特异度分别达到了80.83%,80.61%和81.82%。洗脱液FNA-Tg检测中,89例为阳性,31例为阴性;侧颈部淋巴结转移诊断的准确度、灵敏度和特异度分别达到了89.17%,88.78%和90.91%。FNA+FNA-Tg联合使用时,判定阳性有101例,阴性有19例;侧颈部淋巴结转移诊断的准确度、灵敏度和特异度分别为94.17%、97.96%、77.27%。采用FNA+FNA-Tg方法,较FNA、FNA-Tg,其在诊断PTC转移性颈部侧淋巴结方面展现出更高的准确性,其差异均有统计学意义(χ^(2)=50.64,P<0.001;χ^(2)=64.81,P<0.001)。结论联合FNA+FNA-Tg诊断PTC颈侧淋巴结转移的具有较高的准确性。Objective To investigate the diagnostic value of preoperative fine-needle aspiration(FNA)of lymph nodes combined with washout thyroglobulin testing(FNA-Tg)for detecting lymph node metastasis in papillary thyroid carcinoma(PTC).Methods A prospective study was conducted on 112 patients diagnosed with PTC at Wenzhou Central Hospital from December 2021 to December 2023,all of whom had suspicious lateral cervical lymph node metastasis identified through preoperative ultrasound.All patients underwent lymph node FNA and FNA-Tg.The suspicious lymph nodes were surgically excised.The diagnostic efficacy of FNA,FNA-Tg,and the combination of FNA and FNA-Tg for PTC with lymph node metastasis was compared.Results A total of 112 patients were identified with 120 lymph nodes,among which 98 lymph nodes were confirmed to have metastasis by pathology.The results of the FNA cytology examination revealed 83 positive cases and 37 negative cases.The accuracy,sensitivity,and specificity for diagnosing lateral cervical lymph node metastasis were 80.83%,80.61%,and 81.82%,respectively.In the FNA-Tg,there were 89 positive cases and 31 negative cases,with accuracy,sensitivity,and specificity for diagnosing lateral cervical lymph node metastasis at 89.17%,88.78%,and 90.91%,respectively.When FNA and FNA-Tg were used in combination,there were 101 positive cases and 19 negative cases;the accuracy,sensitivity,and specificity for diagnosing lateral cervical lymph node metastasis were 94.17%,97.96%,and 77.27%,respectively.The combined use of FNA and FNA-Tg demonstrated significantly higher accuracy in diagnosing metastatic lateral cervical lymph nodes in PTC compared to FNA and FNA-Tg alone(χ^(2)=50.64,P<0.001;χ^(2)=64.81,P<0.001).Conclusions The combined use of FNA and FNA-Tg demonstrates high accuracy in diagnosing lateral cervical lymph node metastasis in PTC.

关 键 词：甲状腺肿瘤 活组织检查 细针 甲状腺球蛋白 淋巴转移 手术前期间 

分 类 号：R73[医药卫生—肿瘤]