甲状腺微小乳头状癌超声特征与预测颈侧区淋巴结转移关系的探讨

目的探讨甲状腺微小乳头状癌超声特征与颈侧区淋巴结转移之间的关系。方法选取2009年2月～2010年2月超声诊断的甲状腺微小乳头状癌患者80例,其中颈侧区淋巴结转移阳性患者35例,颈侧区淋巴结转移阴性患者45例。根据超声诊断资料和术后颈侧区淋巴结的病理结果,对超声诊断特征、不同超声积分与颈侧区淋巴结是否转移的关系进行分析。结果①颈侧区淋巴结转移阳性患者超声检查肿瘤边界不清晰、微小钙化、肿瘤位于上极和甲状腺被膜与肿瘤关系〉25.0%的检出率明显高于颈侧区淋巴结转移阴性患者的检出率,差异统计学有意义（P〈0.05）。②颈侧区淋巴结转移阳性患者超声积分为（3.2±0.8）分,颈侧区淋巴结转移阴性患者超声积分为（1.2±0.6）分,差异有统计学意义（t=13.0231,P〈0.05）,以超声积分≥2.5分为临界点,颈侧区淋巴结很有可能发生转移,其诊断敏感性和特异性分别为85.7%、88.9%。结论采取超声积分对甲状腺微小乳头状癌颈侧区淋巴结转移的诊断具有一定的预测意义,在超声积分≥2.5分时,可能提示有颈侧区淋巴结转移情况发生。

Discussion on the relationship between ultrasonic features of papillary thyroid microcarcinoma and the predetermination of the lateral neck lymphatic metastasis

Objective To research on the relationship between ultrasonic features of papillary thyroid microcarcinoma and the predetermination of the lateral neck lymphatic metastasis.Methods 80 cases of papillary thyroid microcarcinoma from February 2009 to February 2010 were selected,35 cases with positive lateral neck lymph node metastasis and 45 cases with negative lateral neck lymph node metastasis were found.The relationship between ultrasonic features,different ultrasonic integral and lateral neck lymphatic metastasis were analyzed according to the ultrasonic diagnostic data and pathological results of postoperative lateral neck area lymph nodes.Results ①Detection rate of indistinct tumor boundary,small microcalcification,the tumor locates on the pole,relationship between tumor of thyroid capsule ＆gt; 25.0% by ultrasonic testing in patients with positive lateral neck lymph node metastasis were higher than those in pa tients with negative lateral neck lymph node metastasis,the differences were statistically significant（P ＆lt; 0.05）.②Ultrasonic integral in patients with positive lateral neck lymph node metastasis were（3.2±0.8） scores,ultrasonic integral in patients with negative lateral neck lymph node metastasis were（1.2±0.6） scores,the differences were statistically significant（t = 13.0231,P ＆lt; 0.05）;ateral neck lymph node was metastasis in the critical point ≥2.5 scores,the sensitivity and specificity were 85.7% and 88.9% respectively.Conclusion There is a certain predicted meaning of the ultrasonography score used in the clinic for diagnosing the papillary thyroid microcarcinoma and the lateral neck lymphatic metastasis,when the ultrasonography score is ≥2.5,this may indicate that the lateral neck lymphatic metastasis will happen.