细针穿刺细胞学检查在甲状腺癌碘-131 治疗后复发诊断中的应用价值

目的 评价甲状腺癌术后碘-131治疗的疗效,并探究超声引导下细针穿刺细胞学检查在碘-131治疗后复发病例诊断中的应用价值。方法 选择2011年1月～2018年5月期间甲状腺癌术后在北京大学深圳医院接受放射性碘治疗的474例患者进行随访,采用影像学检查筛选甲状腺癌患者的复发情况,并对这部分患者进行细针穿刺细胞学检测以评价细针穿刺细胞学在甲状腺癌复发患者中的诊断学价值。结果 474例甲状腺癌患者在接受碘-131治疗后,定期超声影像学筛查,筛查出甲状腺癌复发患者56例,超声影像学诊断筛查出甲状腺癌患者复发率为11.81%,对可疑复发的患者行细针穿刺细胞学检查及组织病理学检查,细针穿刺细胞学检查筛查出甲状腺癌复发患者50例,组织病理学检查证实甲状腺癌复发患者50例,经病理学修正后碘-131治疗后甲状腺癌患者复发率为10.55%,超声影像学检查对甲状腺癌患者复发诊断的符合率89.29%,细针穿刺细胞学诊断复发符合率为100%。结论 超声影像学检查是甲状腺癌患者常规使用的复查手段,而对于超声检查发现的可疑淋巴结进行超声引导下细针穿刺细胞学检查的准确率优于单纯的超声影像学检查。

Application Value of Fine Needle Aspiration Cytology in Recurrence Diagnosis of Thyroid Cancer after Iodine-131 Treatment

Objective To evaluate the efficacy of postoperativeiodine-131 therapy in thyroid cancer, and explore the value of ultrasound-guided fine needle aspiration cytology in the diagnosis of recurrent cases after iodine-131 treatment. Methods Patients who underwent radioactive iodine treatment in Peking University Shenzhen Hospital from January 2011 to May 2018 were selected for follow-up.The recurrence rate of thyroid cancer patients after iodine-131 treatment was calculated, and 56 patients with thyroid cancer recurrence were screened.The diagnostic value of fine needle aspiration cytology in patients with recurrent thyroid cancer was evaluated. Results A total of 474 patients with thyroid cancer who underwent iodine-131 treatment underwent regular ultrasound imaging screening, and 56 patients with thyroid cancer recurrence were screened. The recurrence rate of thyroid cancer patients diagnosed by ultrasound imaging was 11.81%. Fine needle aspiration cytology and histopathological examination were performed in patientswith suspected recurrence, 50 cases of thyroid cancer recurrence were detected by fine needle aspiration cytology, 50 cases of thyroid cancer recurrence confirmed by histopathological examination, pathological correction and the recurrence rate of thyroid cancer patients after treatment with post-iodine-131 was 10.97%. The coincidence rate of ultrasound imaging examination for recurrence diagnosis of thyroid cancer patients was 89.28%, and the coincidence rate of fine needle aspiration cytology diagnosis was 100%. Conclusion Ultrasound imaging is a routine review method for thyroid cancer patients, and the accuracy of ultrasound-guided fine needle aspiration cytology for suspicious lymph nodes detected by ultrasonography is better than that of pure ultrasound imaging.