摘要
目的探讨超声对桥本甲状腺炎（HT）合并甲状腺乳头状癌（PTC）颈部淋巴结转移的诊断价值。方法回顾性分析行甲状腺手术且经病理确诊为PTC的患者278例，按照是否合并HT分为单纯性PTC组（185例）和HT合并PTC组（93例）。研究颈部淋巴结转移的情况及淋巴结转移的超声检出率。结果单纯PTC组颈部淋巴结转移率为59．5％，明显高于HT合并PTC组的45．2%（P=0．024）。术前超声对中央区淋巴结转移的诊断准确率单纯PTC组为53．9％，HT合并PTC组为18．8％，二者差异具有统计学意义（P=0．01）；对侧颈部淋巴结转移的诊断准确率单纯PTC组为79．4％，HT合并PTC组为73．1％，二者差异无统计学意义（P=0．565）。结论单纯PTC的颈部淋巴结转移率高于合并HT的PTC。术前超声对中央淋巴结转移的诊断准确性较低，尤其是对合并HT的PTC；对于侧颈部淋巴结转移的诊断准确性较高，并且不受HT的影响。
Objective To investigate the diagnostic value of ultrasonography for neck lymph node metastasis in papillary thyroid carcinoma （PTC） and Hashimotor s thyroiditis （HT） coexistent with PTC. Methods Two hundred and seventy-eight patients who accepted thyroid surgery were retrospectively reviewed for the pre-operative ultrasonographic and post-operative pathological reports. All patients were confirmed as PTC by surgery and pathology. According to the presence of HT confirmed in pathology, all patients were divided into two groups：group of PTC and group of HT with PTC. The status of neck lymph node metastasis and the diagnostic value of pre-operative ultrasound in detecting neck lymph node metastasis were studied. Results There were 185 cases in the group of PTC, and the rate of neck lymph node metastasis was 59.5%; while there were 93 cases in the group of HT with PTC, in which the rate of neck lymph node metastasis was 45.2%. The difference between the two groups in lymph node metastasis was statistically significant （ P = 0. 024）. The predictive accuracy of pre-operative ultrasound for central neck lymph node was 53.9% in the group of PTC, which was statistically higher than 18.8% in the group of HT with PTC（ P = 0.01 ）. The predictive accuracy of pre-operative ultrasound for lateral neck lymph node was 79.4% in the group of PTC, which had no statistical difference with that in the group of HT with PTC （73.1%, P = 0.565）. Conclusions The neck lymph node metastasis in PTC patients occurs more frequently than that in PTC patients with HT. The value of pre-operative ultrasound examination is lower for the detection of central lymph node metastasis, especially in PTC patients with HT; while ultrasound is more sensitive and accurate for lateral lymph node detection regardless of the existence of HT.
出处
《中华超声影像学杂志》
CSCD
北大核心
2016年第11期962-965,共4页
Chinese Journal of Ultrasonography
基金
国家自然科学基金（81401422）
上海市科学技术委员会引导项目（134119a1500）
上海复旦大学附属肿瘤医院影像专项基金（YX201502）
关键词
超声检查
桥本病
甲状腺肿瘤
淋巴转移
Ultrasonography
Hashimoto＇s disease
Thyroid neoplasms
Lymphatic metastasis
