细针抽吸洗脱液甲状腺球蛋白诊断甲状腺癌中颈部淋巴结转移的应用价值

Clinical value of fine needle aspiration thyroglobulin test in diagnosing cervical lymph node metastasis of thyroid cancer

目的探讨细针抽吸洗脱液甲状腺球蛋白(FNA-TG)在甲状腺癌中颈部淋巴结转移的应用价值。方法回顾性选取2019年6月至2021年6月福建中医药大学附属第二人民医院收治的86例甲状腺癌手术治疗患者作为研究对象,按颈部淋巴结转移情况,分为颈部淋巴结转移病例组(转移组)46例和颈部淋巴结无转移病例组(普通组)40例,86例患者均接受细针穿刺活检(FNAC)和洗脱液检测Tg(FNA-Tg)。将手术切除治疗后的病理检查结果作为金标准,对比86例患者的检查情况。结果FNA-Tg检查结果,转移组(196±35)μg/L高于普通组(17±4)μg/L,差异具有统计学意义(P<0.05)。FNA-Tg诊断特异度较高,敏感度较高,准确度较高,差异具有统计学意义(P<0.05)。颈部淋巴结超声特征与FNAC及FNA-Tg阳性结果的关联性分析显示FNA-Tg检测的结果更好,差异具有统计学意义(P<0.05)。结论FNA-Tg在甲状腺癌颈部淋巴结转移的临床检查中,能有效检出颈部淋巴结转移症状,有较高敏感度、特异度、准确度,值得推广应用。

Objective To investigate the clinical value of fine needle aspiration thyroglobulin(FNA-Tg)test in identifying cervical lymph node metastasis of thyroid cancer.Methods The clinical data of 86 patients with thyroid cancer treated by surgery in the Second People′s Hospital Affiliated to Fujian University of Traditional Chinese Medicine between June 2019 and June 2021 were retrospectively analyzed.According to the cervical lymph node metastasis,all patients were divided into the cervical lymph node metastasis group(metastasis group,n=46)and cervical lymph node non-metastasis group(normal group,n=40).All 86 patients underwent fine-needle aspiration cytology(FNAC)and FNA-Tg testing.Using the pathological findings after surgery as the gold standard,the results of the two tests were compared in the 86 patients.Results The FNA-Tg level in the metastasis group was higher than that in the normal group[(196±35)μg/L vs(17±4)μg/L],with statistically significant difference(P<0.05).Using pathological findings after surgery as the gold standard,comparisons in terms of sensitivity,specificity and accuracy between FNAC and FNA-Tg revealed that FNA-Tg test yielded higher specificity,sensitivity and accuracy with statistically significant differences(all P<0.05).The correlation analyses between the ultrasonic characteristics of cervical lymph nodes and the positive results of FNAC and FNA-TG,FNA-Tg was noted to be in the significantly stronger correlation(P<0.05),showing more usefulness as a test.Conclusion The use of FNA-Tg in diagnosing cervical lymph node metastasis of thyroid cancer may effectively identify whether the subject has signs of cervical lymph node metastasis.The high sensitivity,specificity and accuracy of FNA-Tg test justify its widespread use in clinical setting.