摘要
目的探讨超声造影(contrast-enhanced ultrasound,CEUS)联合穿刺洗脱液甲状腺球蛋白测定(thyroglobulin measurement with fine-needle aspiration,FNA-Tg)对甲状腺乳头状癌(papillary thyroid carcinoma,PTC)侧颈部转移淋巴结的诊断价值,并分析CEUS及FNA-Tg在不同影响因素下的敏感性。方法选取2018年11月至2020年1月福建省肿瘤医院行淋巴结穿刺+清扫术的109例PTC患者共122个淋巴结。患者均行术前CEUS检查及FNA-Tg测定。比较CEUS、FNA-Tg及两者联合对PTC转移淋巴结的诊断效能。分析淋巴结大小、囊性区和高回声区对CEUS和FNA-Tg敏感性的影响。结果122个淋巴结中转移性淋巴结74个,非转移性淋巴结48个,两者的超声特征高回声区、边缘血流差异有统计学意义(均P<0.05),CEUS增强方向及增强均匀度差异有统计学意义(均P<0.05)。CEUS、FNA-Tg及两者联合诊断PTC转移淋巴结的敏感性分别为86.5%、94.6%、100%,特异性分别为50%、95.8%、50%,准确性分别为72.1%、95.1%、80.3%。淋巴结高回声区对CEUS的敏感性有影响(P<0.05),对FNA-Tg的敏感性无影响(P=0.77),淋巴结大小及囊性区对CEUS及FNA-Tg敏感性均无影响(P=0.88、0.95、0.35、0.89)。结论FNA-Tg诊断PTC转移淋巴结特异性及准确性较高,与CEUS联合后敏感性显著提高,且FNA-Tg不受淋巴结大小、囊性区和高回声区的影响,在PTC转移淋巴结的诊断中具有重要意义。
Objective To investigate the values of contrast-enhanced ultrasound(CEUS)and thyroglobulin measurement in fine-needle aspiration(FNA-Tg)in detecting papillary thyroid carcinoma(PTC)metastatic lateral cervical lymph nodes,and analyze the impacts of different factors on the sensitivities of CEUS and FNA-Tg.Methods One hundred and twenty-two lymph nodes from 109 patients who underwent aspiration biopsy and cervical lymphadenectomy nodes were enrolled in Fujian Cancer Hospital from November 2018 to January 2020.CEUS and FNA-Tg results were acquired in all patients.The diagnostic values of CEUS,FNA-Tg and the combination of the two methods were compared in suspicious PTC metastatic lymph nodes.The impacts of lymph nodes size,lymph nodes cystic areas and hyper-echoic areas on the sensitivities of CEUS and FNA-Tg were analyzed.Results Among the 122 lymph nodes,74 were metastasis lymph nodes and 48 were non-metastasis lymph nodes.There were significant differences between them in hyperechoic areas and marginal blood flow(P<0.05).There were significant differences in CEUS enhancement direction and uniformity(P<0.05).The diagnostic sensitivities of CEUS,FNA-Tg and the combination of the two methods were 86.5%,94.6%and 100%,respectively,the specificities were 50%,95.8%and 50%,respectively,the accuracies were 72.1%,95.1%and 80.3%,respectively.The hyper-echoic areas of lymph nodes had effects on the sensitivity of CEUS(P<0.05),while they had no effect on the sensitivity of FNA-Tg(P=0.77).The size and cystic areas of lymph nodes had no effect on the sensitivity of CEUS and FNA-Tg(P=0.88,0.95,0.35,0.89).Conclusions FNA-Tg has high specificity and accuracy in the diagnosis of metastatic lymph nodes in PTC.Combined with CEUS,the sensitivity is significantly improved,and FNA-Tg is not affected by the size of lymph nodes,cystic area and hyper-echoic areas.It is of great significance in the diagnosis of PTC metastatic lymph nodes.
作者
刘娜香
唐丽娜
沈友洪
吴周贵
杜忠实
王瑶琴
黄伟钦
陈轶洁
Liu Naxiang;Tang Lina;Shen Youhong;Wu Zhougui;Du Zhongshi;Wang Yaoqin;Huang Weiqin;Chen Yijie(Department of Ultrasound,Fujian Cancer Hospital,Affiliated Tumor Hospital of Fujian Medical University,Fuzhou 350014,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2020年第12期1060-1066,共7页
Chinese Journal of Ultrasonography
基金
福建省卫生健康科技计划项目(2017-1-14)
国家临床重点专科建设项目资助((2013)544)
福建省科技厅重点项目(2017Y0021)。
关键词
超声检查
淋巴结转移
造影剂
甲状腺乳头状癌
甲状腺球蛋白
Ultrasonography
Lymph node metastasis
Contrast media
Papillary thyroid carcinoma
Thyroglobulin
