甲状腺乳头状癌超声病理特点分析

目的 结合甲状腺乳头状癌的病理特点分析其超声表现特征,以提高甲状腺良恶性肿块的超声诊断及鉴别诊断水平.方法 回顾性分析我院173例乳头状癌的术前超声表现,病灶大小、回声、边界、钙化、内部的血流、颈部淋巴结转移及伴随疾病等.结果 甲状腺乳头状癌年龄平均46.7岁,男女比例为1∶5.41;173例共203个癌灶,乳头状癌灶与微小乳头状癌灶低回声、边界不清比较差异无统计学意义（P值均＞0.05）,前者在血流丰富程度、微小钙化出现率、术前超声诊断率方面均高于后者（P值分别为＜0.01、＜0.05、＜0.01）;173例甲状腺乳头状癌多灶性33.53%（58/173）,其中乳头状癌与微小乳头状癌多灶性比较差异无统计学意义（P＞0.05）,前者淋巴结转移率显著高于后者（P＜0.01）;微小乳头状癌不合并甲状腺其他疾病术前诊断率较合并其他疾病者高（P＜0.05）,乳头状癌有无合并甲状腺其他疾病对诊断率无显著影响（P＞0.05）.结论 综合考虑甲状腺结节直径大小、边界、回声、微小钙化、颈淋巴结转移、结节内血流及伴随疾病等指标能更好地诊断原发性甲状腺乳头状癌.

Analysis of ultrasonic and pathological features of papillary thyroid carcinoma

Objective To improve the ultrasonic differential diagnosis of thyroid lump through analyzing pathological and ultrasonic features of papillary thyroid carcinoma. Methods Records of 173 cases papillary thyroid carcinoma were analyzed retrospectively in terms of preoperative ultrasonic manifestation, lesion size, echo,boundary, calcification, blood supply, lymph node metastasis and accompanying diseases etc. Results The avthe 173 papillary thyroid carcinoma cases, the number of cancer nodule was 203. There was no statistical difference between papillary thyroid carcinoma lesion and papillary thyroid microcarcinoma lesion in terms of low echo and ill-defined borders (P ＞ 0. 05). The former is higher than the latter in blood flow speed, microcalcification rate, and preoperative ultrasonic diagnosis rate (P ＜0. 01, P ＜0. 05, P ＜0. 01 respectively). The mulifocality rate for the 173 cases with papillary thyroid carcinoma is 33.53% (58/173). There was no statistical difference between papillary thyroid carcinoma and papillary thyroid microcarcinoma in cancer lesion(P ＞0. 05), while the former has a higher rate of lymph node metastasis than the latter(P ＜0. 01). Preoperative diagnosis rate is higher in papillary thyroid microcarcinoma cases without other thyroid diseases than in cases with other thyroid diseases (P ＜ 0. 05). No statistical difference of preoperative diagnosis rate was seen between papillary thyroid carcinoma patients with other thyroid diseases and those without other thyroid diseases (P ＞ 0. 05). Conclusions The overall evaluation of thyroid nodule diameter, boundary, echo, small calcification, lymph node metastasis, blood supply, accompanying diseases and so on can improve diagnosis of primary papillary thyroid carcinoma.