超声诊断甲状腺癌颈部淋巴结转移的特点及其临床诊断价值

目的 探究超声诊断甲状腺癌颈部淋巴结转移的特点及其临床诊断价值.方法 选取51例甲状腺癌患者为研究对象,利用超声对患者的甲状腺及颈部肿大淋巴结进行诊断,并将超声诊断结果与术后病理诊断结果进行比较.结果 经超声探测的51例患者颈部转移性淋巴结为109枚,非转移性淋巴结16枚;术后病理检测患者颈部转移性淋巴结98枚,非转移性淋巴结12枚.与术后病理检测结果对比,利用超声检测患者颈部淋巴结转移的准确率为88.0％,敏感度为64.8％,特异度为85.3％,阳性预测值为80.7％,阴性预测值为66.7％.超声对多个淋巴结转移的检出率明显高于单个淋巴结转移的检出率,二者差异有统计学意义(x2=6.736,P=0.031);甲状腺癌肿瘤边界不清或呈锯齿状、肿瘤直径＞2 cm的颈部淋巴结转移率较高,并且转移性淋巴结的血流信号多于非转移性淋巴结,差异有统计学意义(P＜0.05).结论 利用超声诊断甲状腺癌颈部淋巴结转移的准确率较高,可在临床推广应用.

Ultrasonographic Diagnosis of Cervical Lymph Node Metastasis and Its Clinical Diagnostic Value

Objective To investigate the characteristics and clinical value of ultrasonography in the diagnosis of cervical lymph node metastasis of thyroid carcinoma.Methods 51 cases of thyroid cancer patients was selected as the research object,the use of ultrasound on patients with thyroid and enlarged cervical lymph node was diagnosed and the ultrasonic diagnosis results and the postoperative pathological examination results were compared.Results There were 109 metastatic lymph nodes and 16 non-metastatic lymph nodes in 51 patients underwent ultrasonography.There were 98 metastatic lymph nodes and 12 non-metastatic lymph nodes in postoperative pathology.Compared with the results of postoperative pathological examination,the accuracy of ultrasonography for cervical lymph node metastasis was 88.0％,sensitivity was 64.8％,specificity was 85.3％,the positive predictive value was 80.7％ and the negative predictive value was 66.7％.The detection rate of multiple lymph nodes was significantly higher than that of single lymph nodes (x2 =6.736,P =0.031).Thyroid cancer was unclear or serrated,tumor diameter ＞ 2 em,and the blood flow signal of metastatic lymph nodes was more than that of non-metastatic lymph nodes,the difference was statistically significant (P ＜ 0.05).Conclusion Accuracy of ultrasound in the diagnosis of cervical lymph node metastasis is higher,it can be popularized and applied.