甲状腺癌超声分型与病理关系的初步研究

摘要] 目的 探讨甲状腺癌超声分型与病理的关系及临床意义。方法 对49例术后病理证实为甲状腺癌患者的术前彩色多普勒超声声像图进行分型并与病理分型对照,分析各型超声特点及其与病理诊断符合率。结果 根据声像图表现分为4型: Ⅰ型（团块型）22例，病理以乳头状癌为主，占77.3%，本型与病理诊断符合率86.4%；Ⅱ型（结节型）11例，病理为乳头状癌8例，其中6例为微小癌，滤泡型癌3例，本型与病理诊断符合率90.9%；Ⅲ型（多发型）6例，病理为乳头状癌2例，滤泡型癌4例，本型与病理诊断符合率83.3%（5/6）；Ⅳ型（囊实型）10例，病理为乳头状癌5例，滤泡型癌5例，本型与病理诊断符合率40%（4/10）。Ⅰ型、Ⅱ型、Ⅲ型分别与Ⅳ型超声与病理诊断符合率比较差异有显著性(均P<0.05)。结论 甲状腺癌的超声分型与病理密切相关，囊实型声像图为甲状腺癌的不典型声像图。

Study on relationship between sonographic types and pathology of thyroid carcinoma

Objective To probe the relationship between sonographic types and pathology of thyroid carcinoma and assess the clinic significance. Methods Preoperative ultrasonography in 49 cases with thyroid carcinoma were categorized.The relationship between the sonographic types and the pathology, and the diagnostic accuracy of ultrasonography correlated to the pathology were analyzed. Results According to their different ultrasonographic appearances, 49 cases of thyroid carcinoma were divided into four types: Type I-Lump Type in 22cases,of which 17 cases were with papillary carcinoma in pathology, and the concordance rate was 86.4%;TypeⅡ-Nodal Type in 11 cases, of which 8 cases were with papillary carcinoma and 3 cases with follicular carcinoma, and the concordance rate was 90.9%;TypeⅢ- Multiple Type in 6 cases, of which 2 cases were with papillary carcinoma and 4 cases with follicular carcinoma, and the concordance rate was 83.3%;TypeⅣ- Cystiform Type in 10 cases, of which 5 cases were with papillary carcinoma and 5 cases with follicular carcinoma, and the concordance rate was 40%。There was statistically difference in the diagnostic accuracy of ultrasound between TypeⅠ and Ⅳ, between Type Ⅱand Ⅳ, and between Type Ⅲand Type Ⅳ (all p＜0.05）.Conclusion There was a close relation between sonographic types and pathology of thyroid carcinoma. The ultrasonographic pattern of Cystiform Type is one of atypical signs of thyroid carcinoma in ultrasound.