摘要
目的探讨术前CT增强检查评估甲状腺微小乳头状癌颈部淋巴结转移的临床价值。方法经临床病理证实的甲状腺微小乳头状癌患者526例。以淋巴结病理切片结果定为金标准，评估CT增强检查对发现颈部淋巴结转移，中央组淋巴结转移，颈侧组淋巴结转移的敏感度、特异度、阳性预测值及阴性预测值。结果共518例患者行颈部淋巴结清扫，8例未行颈部淋巴结清扫。术前CT增强检查评估颈部淋巴结有无转移的敏感度为69．9％，特异度为94．1％，阳性预测值为82．2％，阴性预测值为88．8％；评估中央组淋巴结有无转移的敏感度为57．O％，特异度为94．5％，阳性预测值为81％，阴性预测值为85．4％；评估颈侧组淋巴结有无转移的敏感度为82．1％，特异度为98．1％，阳性预测值为82．5％，阴性预测值为98．3％。颈部中央组发现淋巴结转移的同时，同侧颈侧组淋巴结转移的发生率为28．9％。结论未前CT增强对于中央组淋巴结转移的敏感度较低，而对于颈侧组淋巴结转移的敏感度及特异度均较高，对临床手术是否有必要清扫颈侧组淋巴结有指导意义。
Objective To investigate the clinical value of preoperative enhanced CT examination for cervical lymph node metastasis in papillary thyroid microearcinoma （ PTMC ） . Methods A retrospective analysis of 526 cases of papillary thyroid carcinoma were performed, which was confirmed by clinic and pathology in our hospital. The gold standard was determined by the pathological sections of lymph nodes. The enhanced CT examination in Evaluating cervical lymph nodes metastasis, to analyze and calculate sensitivity, specificity, positive predictive value （ PPV ） and negative predictive value （ NPV ） of the central lymph node metastasis, and the lateral neck lymph node metastasis. Results A total of 518 patients underwent routine lymph node dissection, 8 patients did not undergo lymph node dissection. The sensitivity for detecting cervical lymph node metastasis was 69.9%, specificity 94.1%, PPV 82.2% and NPV 88.8%; The sensitivity for detecting central lymph nodes metastasis was 57.0%, specificity 94.5%, PPV 81%, NPV 85.4%; The sensitivity for detecting lateral lymph nodes metastasis was 82.1%, specificity 98.1%, PPV 82.5%, NPV 98.3%. The incidence rate of central lymph node metastasis with homolateral lateral neck lymph node metastasis was 28.9%. Conclusion The sensitivity of preoperative enhanced CT examination for detecting central lymph node metastasis is low, however the sensitivity and specificity of preoperative enhanced CT for detecting lateral neck lymph node metastasis is higher. It may be necessary to guide the clinical surgery whether to clean the lateral neck lymph node.
出处
《浙江临床医学》
2016年第8期1513-1514,共2页
Zhejiang Clinical Medical Journal
关键词
CT
甲状腺肿瘤
乳头状癌
淋巴结转移
Computed Tomography Thyroid cancer Papillary carcinoma Lymph node metastasis
