超声弹性成像对甲状腺乳头状癌颈部淋巴结跳跃性转移的评估价值

Value of sonoelastography in the evaluation of skip metastasis of cervical lymph nodes in papillary thyroid carcinoma

目的:探讨超声弹性成像对甲状腺乳头状癌颈部淋巴结跳跃性转移的评估价值。方法:选取西南医科大学附属医院2020年3月—2021年8月收治的82例甲状腺乳头状癌患者的相关资料,共114个结节,以术后病理学结果为金标准。给予所有患者超声弹性成像检查,其中发生淋巴结跳跃性转移的22例患者设为观察组,共36个结节,未发生淋巴结跳跃性转移的60例患者设为对照组,共78个结节。比较两组患者甲状腺乳头状癌结节弹性评分(ES)情况与弹性应变率(SR),并分析超声弹性成像对甲状腺乳头状癌颈部淋巴结跳跃性转移的评估价值。结果:两组患者结节E S比较无显著差异(Z=0.320,P=0.749>0.05),观察组SR(2.64±0.35)显著高于对照组的(1.78±0.37)(t=9.457,P<0.05);超声弹性成像评估甲状腺乳头状癌颈部淋巴结跳跃性转移的灵敏度为77.78%,特异度为79.49%,准确率为78.95%,说明超声弹性成像技术检查具有一定评估价值。结论:超声弹性成像对甲状腺乳头状癌颈部淋巴结跳跃性转移具有较好的评估价值,其诊断灵敏度为77.78%,特异度为79.49%,准确率为78.95%,可为临床提供一定参考依据。

Objective To investigate the value of sonoelastography in evaluating skip metastasis of cervical lymph nodes in papillary thyroid carcinoma.Methods A total of 82 patients(114 nodules in total)with papillary thyroid carcinoma admitted to Affiliated Hospital of Southwest Medical University from March 2020 to August 2021 were retrospectively analyzed,with the postoperative pathological results as the gold standard.All patients were given sonoelastography,of which 22 patients with skip lymph node metastasis were used as the observation group,with a total of 36 nodules,and 60 patients without skip lymph node metastasis were used as the control group,with a total of 78 nodules.The elasticity score(ES)and elastic strain rate(SR)of papillary thyroid carcinoma nodules were compared between the two groups,and the value of sonoelastography in evaluating skip metastasis of cervical lymph nodes in papillary thyroid carcinoma was analyzed.Results There was no significant difference in ES between the two groups(Z=0.320,P=0.749>0.05).SR in the observation group(2.64±0.35)was significantly higher than that in the control group(1.78±0.37)(t=9.457,P<0.05).The sensitivity,specificity and accuracy of sonoelastography in evaluating skip metastasis of cervical lymph nodes in papillary thyroid carcinoma were 77.78%,79.49%and 78.95%,indicating that sonoelastography has certain evaluation value.Conclusion Ultrasound elastography has a good value in evaluating skip metastasis of cervical lymph nodes in papillary thyroid carcinoma,its diagnostic sensitivity was 77.78%,specificity was 79.49%,and accuracy was 78.95%,which can provide some reference for clinical practice.