摘要
目的评价彩超在诊断甲状腺癌患者颈淋巴结转移中的作用。方法回顾性分析1998年2月～2002年2月收治51例颈淋巴转移的甲状腺癌患者的临床资料:30例(34侧)颈部可触及有肿大淋巴结并经彩超检查诊断有颈淋巴结转移;21例(24侧)颈部未触及有肿大淋巴结但彩超检查诊断有颈淋巴结转移。对上述58侧颈部实行改良性颈清扫,将术前彩超检查结果与术后病理结果进行比较。结果彩超诊断有颈淋巴结转移的58侧行改良性颈清扫术后53侧病理报告有转移淋巴结,彩超检查的灵敏度为91.4%(53/58)。4例患者在随访过程中发现颈侧区淋巴结转移,复发率为7.5%。彩超可以发现39.6%有临床漏诊颈淋巴结转移的患者。术前彩超检查:中颈淋巴转移率最高71.7%(38/53);术后病理检查:Ⅲ区淋巴转移率最高67.9%(36/53),其结果基本相同。结论彩超在术前可以判断是否发生颈淋巴结转移并能够准确定位,在甲状腺癌的术前颈淋巴结的评价中十分重要,甲状腺癌患者应常规进行术前彩超检查。
OBJECTIVE To evaluate the role of preoperative ultrasonograpy in detecting cervical lymph node metastasis. METHODS Medical records between February 1998 and February 2002, consisting of 51 cases （58 sides） of well-differentiated thyroid carcinoma with cervical lymph nodes metastasis, were reviewed. Patients were divided into 2 groups： group 1, 34 cervical sides with palpable cervical lymph nodes preoperatively and group 2, 24 cervical sides with impalpable nodes but positive for nodal metastasis ultrasonically. All patients underwent modified neck dissection. The preoperative ultrsonographic results and preoperative pathologic findings were compared. RESULTS Of the 58 sides with positive preoperative ultrsonographic results, 53 sides had been demonstrated to have cervical lymph nodes metastasis pathologically. The sensitivity of ultraonography was 91.4 %（53/58）. Four patients had developed lateral cervical recurrence during the course of the follow-up, yielding a recurrence rate of 7.5 %. Ultrasonography detected cervical lymph node believed to be uninvolved by physical examination in 39.6 % of patients. The most frequent involvement site was middle neck according to ultrasonography [71.7 %（38/53）] and level III according to pathological findings [67.9 %（36/53）]. CONCLUSION Preoperative ultrasonograpy is a basis for detecting cervical lymph nodes metastasis in thyroid cancer patients. It can detect metastatic cervical lymph nodes and their Iocalizations. All thyroid cancer patients should undergo preoperative ultrasonography.
出处
《中国耳鼻咽喉头颈外科》
北大核心
2006年第4期211-214,共4页
Chinese Archives of Otolaryngology-Head and Neck Surgery
关键词
甲状腺
癌
肿瘤转移
颈淋巴结清扫术
超声检查
Thyroid Gland
Carcinoma
Neoplasm Metastasis
Neck Dissection
Ultrasonography
