摘要
目的分析甲状腺乳头状癌(PTC)术前超声及其引导下细针穿刺细胞学(FNAC)检查的诊断价值及特征表现。方法收集我院2014年1月—2017年2月收治的129例(148个PTC结节)经术中病理确诊为PTC患者的术前超声、FNAC检查资料,对超声及FNAC检查的诊断报告及特征描述进行回顾性分析。结果 148个PTC结节的超声表现主要有:实质性低回声(125/148,84.5%)、内部回声不均(91/148,61.5%)、结节纵横比≥1(115/148,77.7%)、边界模糊(103/148,69.6%)、伴有微小钙化(111/148,75.0%)、无或有不完整晕环(144/148,97.3%)、有丰富血流信号(96/148,64.9%)和颈部肿大淋巴结(9/129,7.0%)。148个PTC结节的FNAC诊断为:考虑或可疑PTC 116个(78.4%),恶性肿瘤2个(1.4%),意义不明确的细胞非典型病变17个(11.5%),良性滤泡性结节2个(1.4%),滤泡性肿瘤1个(0.7%),标本不满意或无法诊断10个(6.7%);如将"考虑或可疑PTC和恶性肿瘤"定义为细胞学诊断准确,则FNAC诊断准确率为79.7%。结论超声和FNAC检查对于PTC的术前诊断具有较高的诊断准确率和典型的表现,有助于PTC患者的早期诊断及治疗方案的制定。
Objective To analysis the diagnostic values and characteristics of ultrasound and ultrasound guided fineneedle aspiration cytology(FNAC)in patients with papillary thyroid carcinoma(PTC)before operation.Methods The dataof ultrasound and ultrasound guided FNAC in129patients(including148PTC nodules)with PTC were collected fromJanuary2014to February2017,and the diagnostic reports and feature descriptions of ultrasound and ultrasound guidedFNAC were analyzed retrospectively.Results Among the148PTC nodules,the ultrasonographic imaging showed that84.5%(125/148)with low echo-level solid nodules,61.5%(91/148)with echo heterogenicity,77.7%(115/148)with aratio≥1in longitudinal/breadth,69.6%(103/148)with fuzzy boundary,75.0%(111/148)with microcalcification innodules,97.3%(144/148)without or with incomplete aureole,64.9%(96/148)with rich blood flow and7.0%(9/129)withenlargement of cervical lymph nodes.The FNAC diagnosis showed that78.4%(116/148)was diagnosed with suspectedpapillary carcinoma,1.4%(2/148)was diagnosed with malignent tumor,11.5%(17/148)was diagnosed with atypia ofundetermined significance(AUS),1.4%(2/148)was diagnosed with benign lesion,0.7%(1/148)was diagnosed withfollicular neoplasm and6.7%(10/148)could not be diagnosed.If the suspected papillary carcinoma and malignent tumorwere defined as cytodiagnosis,the diagnostic accordance rate with intraoperative pathology was79.7%.Conclusion Thepreoperative accuracy rates of ultrasound diagnosis and ultrasound guided FNAC diagnosis for patients with PTC are high,and the characteristics of the both are also typical.The two examinations before operation are helpful for early diagnosis andtreatment formulation for patients with PTC.
作者
朱晓静
施中元
魏燕华
赵敏
李洁
ZHU Xiao-jing;SHI Zhong-yuan;WEI Yan-hua;ZHAO Min;LI Jie(Department of Pathology,Nanjing 210028, China;Department of Ultrasound, Integrated Chinese and Western Medicine Hospital of Jiangsu Province, Nanjing 210028, China)
出处
《天津医药》
CAS
2017年第5期533-535,共3页
Tianjin Medical Journal
