摘要
目的:探讨甲状腺癌颈部淋巴结转移的规律,评价术前超声分区诊断甲状腺癌颈部淋巴结转移的临床价值。方法:回顾性分析行颈部淋巴结清扫手术的568例甲状腺癌患者的临床资料,术前均行甲状腺超声检查,同时对颈部转移性淋巴结进行分区,记录淋巴结的数量及在颈部Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅵ及Ⅻ区的分布,与术后病理进行比较。结果:超声诊断甲状腺癌的符合率为88%,392倒淋巴结阳性病例中289例患者为多分区转移,转移性淋巴结在颈部的分布以Ⅱ、Ⅲ、Ⅳ、Ⅵ区为主,Ⅴ、Ⅻ区转移性淋巴结分布较少。术前超声对颈部淋巴结诊断的总体符合率为80%,术前超声分区对Ⅲ、Ⅳ、Ⅵ及Ⅶ区的转移性淋巴结的诊断符合率较高。结论:术前超声诊断转移性淋巴结的临床符合率较高。甲状腺癌的颈部淋巴转移为多分区分布,术前超声分区对Ⅲ、Ⅳ、Ⅵ及Ⅶ区转移性淋巴结的诊断符合率较高,可以做到定位、定性及定量诊断,指导临床手术方式的选择,患者术前行超声检查时应常规对颈部淋巴结进行术前分区。
Objective： To study the characteristics of cervical lymph node metastasis of thyroid cancer and to evaluate the clinical value of preoperative ultrasound detection in diagnosingcervical lymph node metastasis of thyroid cancer. Methods： We retrospectively analyzed 568 thyroid cancer patients who underwent cervical lymph node dissection. All of the patients had preoperative thyroid ultrasonography and identification of the areas of cervical lymph node metastasis. The numbers of lymph nodes distributed in Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ Ⅵ and Ⅻ areas were recorded. The results were compared with those of postoperative pathology. Results： The accordance rate of thyroid ultrasonography in diagnosing thyroid cancer was 88%. Of the 392 patients with positive lymph nodes, 289 had cervical lymph node metastasis in more than one area, mainly in. Ⅱ、Ⅲ、Ⅳ, and Ⅵ areas （P〈0.01）. The accordance rate of preoperative ultrasonography in diagnosing cervical lymph node metastasis was 80%. The diagnositic rate was high for metastatic lymph nodes in Ⅲ, Ⅳ, Ⅵ and Ⅶ areas. Conclusion： The diagnostic rate of preoperative ultrosonography for cervical lymoh node metastasis is high. Cervical lymph node metastasis of thyroid cancer involves more than one area. For patients with thyroid cancer, localization diagnosis, qualitative diagnosis, and quantitative diagnosis can be achieved through pretoperative ultrasonography, guiding the subsequent surgical treatment. Preoperative ultrasonography should be an routine for detection of cervical lymph node metastasis of thyroid cancer.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2010年第16期917-920,共4页
Chinese Journal of Clinical Oncology
关键词
甲状腺癌
淋巴结转移
术前超声检查
Thyroid carcinoma
Lymph node metastasis
Preoperative ultrasonography
