US-FNAB对甲状腺癌颈部淋巴结转移的诊断及甲状腺癌颈部转移性淋巴结的危险因素分析

Diagnosis of Cervical Lymph Nodes Metastasis of Thyroid Cancer by US-FNAB and Analysis of Risk Factors of Cervical Metastatic Lymph Nodes in Thyroid Cancer

目的:探讨超声引导下细针穿刺抽吸活检(ultrasound-guided fine-needle aspiration biopsy,US-FNAB)在甲状腺癌颈侧区淋巴结转移中的诊断价值,并对颈部转移性淋巴结的危险因素进行分析。方法:研究对象选取2019年1月-2022年6月广东医科大学附属医院收治的136例甲状腺癌患者,所有患者均行彩色多普勒超声和US-FNAB检查,将检查结果与术后病理学结果比较。采用单因素和多因素分析甲状腺癌颈部转移性淋巴结的危险因素。结果:US-FNAB对甲状腺癌颈侧区淋巴结转移诊断的敏感度、特异度、阳性预测值、阴性预测值及准确度均高于超声检查(P<0.05)。经多因素分析结果显示,多发病灶数、双侧病灶部位、肿瘤直径≥1 cm、肿瘤侵犯被膜为影响甲状腺癌颈部转移性淋巴结的独立危险因素(P<0.05)。结论:US-FNAB检测甲状腺癌颈侧区淋巴结转移的敏感度、特异度和准确度均较高,多发病灶数、双侧病灶部位、肿瘤直径≥1 cm、肿瘤侵犯被膜为甲状腺癌颈部转移性淋巴结的危险因素,临床可根据危险因素对患者采取及时的诊治措施。

Objective: To explore the diagnostic value of ultrasound-guided fine-needle aspiration biopsy(US-FNAB) in cervical lymph nodes metastasis of thyroid cancer, and to analyze the risk factors of cervical lymph nodes metastasis. Method: A total of 136 patients with thyroid cancer who were admitted to Affiliated Hospital of Guangdong Medical University from January 2019 to June 2022 were selected as the research subjects. All patients underwent color doppler ultrasound and US-FNAB examination, and the examination results were compared with the postoperative pathological results. Univariate and multivariate were used to analyze risk factors for cervical lymph nodes metastasis in thyroid cancer. Result: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of US-FNAB in the diagnosis of lymph nodes metastasis in the cervical region of thyroid cancer were higher than those of ultrasonography(P<0.05). Multivariate analysis showed that the number of multiple lesions,bilateral lesion sites, tumor diameter ≥1 cm and tumor invasion to capsule were the independent risk factors for cervical metastatic lymph nodes of thyroid cancer(P<0.05). Conclusion: US-FNAB has high sensitivity, specificity and accuracy in detecting lymph nodes metastasis in the cervical region of thyroid cancer. The number of multiple lesions, bilateral lesion sites, tumor diameter ≥1 cm and tumor invasion to capsule are the independent risk factors for cervical metastatic lymph nodes of thyroid cancer. Timely diagnosis and treatment measures can be taken for patients clinically according to the risk factors.