105例分化型甲状腺癌的超声比较分析

Comparative Analysis of 105 Patients' Sonographic Features in Differentiated Thyroid Cancer

目的分析比较105例分化型甲状腺癌的超声声像图特点,探讨其对分化型甲状腺癌的诊断价值,降低术前超声误诊率。方法回顾性分析105例分化型甲状腺癌患者的术前超声声像图,按照术后病理结果分为甲状腺乳头状癌组(PTC组)和甲状腺滤泡癌组(FTC组),对两组癌结节的大小、回声水平、边界、形态、钙化及转移情况进行比较分析。结果 PTC组的癌结节较小(10.22±4.94mm),以低回声为主(80.00%,84/105),边界模糊(84.76%,89/105),形态不规则(86.67%,94/105),伴微小钙化(78.09%,82/105),有颈部淋巴结转移(34.78%,32/92);FTC组的癌结节较大(15.25±6.13mm),低回声比例高(71.43%,10/14),边界清晰(57.14%,8/14),形态规则(64.29%,9/14),多无钙化(57.14%,8/14),少部分可伴边缘钙化(28.57,4/14),易发生血行转移(30.77%,4/13)。结论 PTC超声表现典型,临床上较易鉴别,对缺乏恶性征象FTC术前超声可根据病灶大小、钙化及转移特点结合细针穿刺结果判断结节良恶性,有效地减少临床误诊。

Objective To investigate and compare the sonographic findings,and explore the diagnostic value,reduce the preoperative misdiagnosis rate. Methods Recording uhrasonographic data of 105 patients with differentiated thyroid cancer before surgery was per- formed. According to the postoperative pathologic results,the patients were divided into the papillary thyroid carcinoma group（ PTC group） and follicular thyroid carcinoma group （ FTC group）. Statistical analysis of their size, echo, boundary, shape, calcification and transfer was made. Results Nodules of PTC were smaller（ 10.22 ± 4.94mm） , low echo （ 80.00% , 84/105 ）, fuzzy boundary （ 84.76% , 89/105 ）, irregular form （ 86.67 % , 94/105 ） , tiny calcification （ 78.09% , 82/105 ） , neck lymph node transfer （ 34.78% , 32/92 ）. Nodules of FTC were bigger（ 15.25 ±6.13mm） ,low echo（71.43% ,10/14） ,clear boundary（57.14% ,8/14）, regular form（64.29% ,9/14） ,no calcifications（ 57.14% ,8/14）, a small number of it with edge calcification （28.57% ,4/14）, blood metastasis（ 30.77% ,4/13 ）. Conclusion Sonographic findings of PTC is typical and easy to identify. FTC is lack of malignant signs,but according to the size,calcification,transfer characteristics and fine needle biopsy results can effectively reduce clinical misdiagnosis.