甲状腺癌CT-手术-病理对照研究

A Controlled Study of CT-Surgery-Pathology of Thyroid Cancer

目的探讨甲状腺癌CT-手术-病理对照研究的应用价值。方法选取2018年1月至2019年5月本院收治疑似甲状腺癌患者255例,经手术病理组织学诊断确诊为甲状腺癌患者194例。患者术前采用多层螺旋CT(MSCT)与彩色多普勒超声进行检查,以手术病理诊断为“金标准”,观察患者的手术病理结果,将CT与超声诊断结果与手术病理结果进行对比,评估CT对甲状腺癌的阳性检出率、准确率、误诊率、漏诊率、灵敏度及特异度。结果手术病理检测出双侧发病8例,单侧发病186例,左侧发病99例,右侧发病97例,直径>1cm的143例,直径≤1cm的51例;乳头状甲状腺癌117例,甲状腺滤泡状腺瘤69例,未分化癌6例和髓样癌2例。CT检测的准确率、阳性检出率、灵敏度与特异度分别为79.61%、57.22%、78.35%、83.60%,高于B超(64.31%、50.19%、65.98%、59.02%,P<0.05);CT检测的漏诊率、误诊率为16.47%、3.92%,低于B超单项检测(25.88%、9.80%,P<0.05)。结论CT检测对甲状腺癌均有较高的诊断准确率、灵敏度与特异度,能较为精准地体现病灶的具体形态,体现病灶与健康组织间的关系,减少漏诊率与误诊率,可作为甲状腺癌早期诊断的有效方法。

Objective To explore the value of CT-surgery-pathology controlled study of thyroid cancer.Methods 255 patients with suspected thyroid cancer admitted to the hospital between January 2018,and May 2019 were selected.Among them,194 patients with thyroid cancer were confirmed by surgical histopathological diagnosis,and all subjects completed multi-slice spiral CT(MSCT)and color Doppler ultrasound examinations,taking surgical pathological diagnosis as the"gold standard".The patients’surgical pathological results were observed and compared with CT and ultrasound diagnosis results to evaluate the positive detection rate,accuracy,misdiagnosis rate,missed diagnosis rate,sensitivity,and specificity of CT for thyroid cancer.Results Surgical pathology detected 8 cases with the bilateral onset and 186 cases with unilateral onset,99 cases on the left side and 97 cases on the right side,143 cases with diameter>1cm,and 51 cases with diameter≤1cm.There were 117 cases with papillary thyroid carcinoma,69 cases with follicular adenoma,6 cases with undifferentiated carcinoma,and 2 cases with medullary carcinoma.The accuracy,positive detection rate,sensitivity and specificity of CT(79.61%,57.22%,78.35%and 83.60%)were higher than those of B ultrasound[64.31%,50.19%,65.98%and 59.02%(P<0.05)].The missed diagnosis rate and misdiagnosis rate of CT(16.47%and 3.92%)were lower than those of B ultrasound(25.88%and 9.80%,P<0.05).Conclusion The diagnostic accuracy,sensitivity,and specificity of CT for thyroid cancer are high.It can accurately reflect the specific shape of the lesion,reflect the relationship between the lesion and healthy tissues,and reduce the missed diagnosis and misdiagnosis rates.It can be used as an effective method for the early diagnosis of thyroid cancer.