超声引导FNA及FNA-Tg识别甲状腺乳头状癌淋巴结转移的价值

The Value of Ultrasound-guided FNA and FNA-Tg in Identifying Lymph Node Metastasis in Papillary Thyroid Cancer

目的 探究识别甲状腺乳头状癌淋巴结转移时应用超声引导细针穿刺细胞学(fine needle aspiration, FNA)及细针穿刺洗脱液甲状腺球蛋白(fine needle aspiration-thyroglobulin, FNA-Tg)检查的价值。方法 选取2021年1月—2023年5月泰州市中医院疑似甲状腺乳头状癌淋巴结转移患者115例,均对其进行超声引导FNA及FNA-Tg,金标准为手术病理检查,对超声引导FNA及FNA-Tg诊断结果、诊断效能进行分析比较。结果 经手术病理确诊阴性36例,阳性79例;采用FNA-Tg确诊阴性40例,阳性75例;采用FNA确诊阴性57例,阳性58例。FNA-Tg阳性检出率(65.22%)、灵敏度(93.67%)、阴性预测值(87.50%)、准确率(94.78%)高于FNA,漏诊率(6.33%)低于FNA,差异有统计学意义(P<0.05)。结论 在识别甲状腺乳头状癌淋巴结转移患者时,采用FNA-Tg诊断技术,诊断效果较为显著,能够规避诸多因素对结果的影响,在临床识别方案中值得大范围推广与实施。

Objective To investigate the value of ultrasound-guided fine needle aspiration(FNA)and fine needle aspiration-thyroglobulin(FNA-Tg)examination in identifying lymph node metastasis of papillary thyroid cancer.Methods A total of 115 patients with suspected lymph node metastasis of papillary thyroid carcinoma in Taizhou Hospital of Traditional Chinese Medicine from January 2021 to May 2023 were selected for ultrasound-guided FNA and FNA-TG.The gold standard was surgical pathological examination.The diagnostic results and diagnostic efficacy of ultrasound-guided FNA and FNA-TG were analyzed and compared.Results There were 36 negative cases and 79 positive cases after operation and pathology.FNA-Tg was used to confirm 40 negative cases and 75 positive cases.FNA confirmed 57 negative cases and 58 positive cases.The positive detection rate(65.22%),sensitivity(93.67%),negative predictive value(87.50%)and accuracy(94.78%)of FNA-TG were higher than those of FNA,and the missed diagnosis rate(6.33%)was lower than that of FNA,the difference was statistically significant(P<0.05).Conclusion In identifying patients with lymph node metastasis of papillary thyroid cancer,the diagnostic technique of FNA-Tg has a more significant diagnostic effect and can circumvent the influence of many factors on the results,which is worthy of wide-scale promotion and implementation in the clinical identification program.