甲状腺乳头状癌中央区淋巴结转移诊断中超声的应用价值

The Value of Ultrasound in the Diagnosis of Central Lymph Node Metastasis of Papillary Thyroid Carcinoma

目的 探讨甲状腺乳头状癌中央区淋巴结转移诊断中超声的应用价值。方法 选取本院收治的80例甲状腺乳头状癌患者作为研究对象,均进行超声扫描诊断,分析超声和病理诊断结果及有无甲状腺乳头状癌中央区淋巴结转移的超声比较。结果 80例患者中,病理诊断结果显示甲状腺乳头状癌中央区淋巴结转移38例,超声诊断出甲状腺乳头状癌中央区淋巴结转移27例。以病理结果作为金标准,超声诊断甲状腺乳头状癌中央区淋巴结转移的灵敏度为60.5%(23/38),特异度为90.5%(38/42),准确率为76.3%(61/80),阳性预测值为85.2%(23/27),阴性预测值为71.7%(38/53)。有无甲状腺乳头状癌中央区淋巴结转移的比较显示年龄、纵横比、后方回声、淋巴结内部血供比较无显著差异(P>0.05);结节最大径、包膜侵犯、微钙化分布、淋巴结形态结构比较有显著差异(P<0.05)。结论 结节最大径≥1.5cm、包膜侵犯、微钙化分布、淋巴结形态结构异常是甲状腺乳头状癌中央区淋巴结转移患者的重要超声表现,可作为术前清扫和治疗方案的可靠参考。

Objective To investigate the value of ultrasonography in the diagnosis of central lymph node metastasis of papillary thyroid carcinoma.Methods 80 cases of papillary thyroid carcinoma admitted to our hospital were selected as the research objects,all of which were diagnosed by ultrasonic scan.The results of ultrasonic and pathological diagnosis were analyzed and compared with those of central lymph node metastasis of papillary thyroid carcinoma.Results Among the 80 patients,38 cases showed central lymph node metastasis of papillary carcinoma and 27 cases showed central lymph node metastasis of papillary carcinoma.Using the pathological results as the gold standard,the sensitivity and specificity of ultrasound in the diagnosis of central lymph node metastasis of papillary thyroid carcinoma were 60.5%(23/38),90.5%(38/42),and 76.3%(61/80),with positive predictive value was 85.2%(23/27),the negative predictive value was 71.7%(38/53).There were no significant differences in age,aspect ratio,posterior echo and internal blood supply of lymph nodes in the central region of papillary thyroid carcinoma(P>0.05).There were significant differences in the maximum diameter of nodules,capsular invasion,microcalcification distribution and lymph node morphology and structure(P<0.05).Conclusion The maximum diameter of nodule≥1.5cm,capsule invasion,microcalcification distribution,and abnormal morphology and structure of lymph nodes are important ultrasonic findings in patients with central lymph node metastasis of papillary thyroid carcinoma,which can be used as an effective prediction of preoperative dissection and treatment.