摘要
目的探讨超声造影联合细针穿刺细胞学检查(FNA)对甲状腺乳头状癌(PTC)侧颈淋巴结转移的诊断意义。方法回顾性分析2019年1月至2021年7月在湖北省肿瘤医院行手术治疗的94例PTC患者。患者术前均行超声造影及FNA检查。观察患者的手术病理结果,根据病理结果分组,比较恶性淋巴结与良性淋巴结超声特征。以术后病理为金标准,评价并比较超声造影、FNA及2者联合对PTC侧颈淋巴结转移的诊断效能。结果94例患者,共105个颈部淋巴结,其中术后病理证实恶性淋巴结67个(63.81%),良性淋巴结38个(36.19%)。超声造影表现对比,恶性淋巴结向心性增强比率、不均匀增强比率(94.03%、80.60%)均显著高于良性淋巴结(55.26%、23.68%),差异有统计学意义(P<0.05)。超声造影诊断PTC淋巴结转移的敏感度为85.07%,特异度为55.26%,准确度为74.29%;FNA的敏感度为71.64%,特异度为100.00%,准确度为79.05%;2者联合的敏感度为95.52%,特异度为55.26%,准确度为80.95%;2者联合的敏感度相比单项检查显著提高,差异有统计学意义(P<0.05)。结论超声造影、FNA均是诊断PTC侧颈淋巴结转移的有效检查方法,2者联合可显著提高诊断的敏感度。
Objective To investigate the diagnostic significance of contrast-enhanced ultrasound(CEUS)combined with fine needle aspiration cytology(FNA)in lateral cervical lymph node metastasis of papillary thyroid carcinoma(PTC).Methods 94 patients with PTC who underwent surgical treatment in Hubei Cancer Hospital from January 2019 to July 2021 were retrospectively analyzed.CEUS and FNA were performed before operation.The surgical pathological results of the patients were observed,grouped according to the pathological results,and the ultrasound characteristics of malignant lymph nodes and benign lymph nodes were compared.With postoperative pathology as the gold standard,the diagnostic efficacy of CEUS,FNA and their combination on PTC lateral cervical lymph node metastasis was evaluated and compared.Results There were 105 cervical lymph nodes in 94 patients,including 67(63.81%)malignant lymph nodes and 38(36.19%)benign lymph nodes.CEUS showed that the proportion of centripetal enhancement and uneven enhancement of malignant lymph nodes(94.03%,80.60%)were significantly higher than those of benign lymph nodes(55.26%,23.68%),and the differences were statistically significan(P<0.05).The sensitivity,specificity and accuracy of CEUS in the diagnosis of PTC lymph node metastasis were 85.07%,55.26%and 74.29%,respectively.The sensitivity,specificity and accuracy of FNA were 71.64%,100.00%and 79.05%,respectively.The sensitivity,specificity and accuracy of the combination were 95.52%,55.26%and 80.95%,respectively.The sensitivity of the combination of the two was significantly higher than that of the single test,and the difference was statistically significant(P<0.05).Conclusion CEUS and FNA are both effective methods for the diagnosis of PTC lateral cervical lymph node metastasis,and their combination can significantly improve the sensitivity of diagnosis.
作者
梅丽丽
梅志丹
朱艳艳
康莹
耿霞飞
MEI Li-li;MEI Zhi-dan;ZHU Yan-yan(Department of Ultrasound,Hubei Cancer Hospital,Wuhan Hubei 430070,China;Head and Neck Surgery,Hubei Cancer Hospital,Wuhan Hubei 430070,China)
出处
《临床和实验医学杂志》
2021年第22期2459-2462,共4页
Journal of Clinical and Experimental Medicine
基金
湖北省卫生健康委员会科研项目(编号:WJ2019F188)。
关键词
甲状腺癌
乳头状
超声造影
细针穿刺细胞学
淋巴结转移
Thyroid cancer
Papillary
Contrast-enhanced ultrasonography
Fine needle aspiration
Lymph node metastasis
