囊液分析鉴别甲状腺良、恶性囊肿的临床意义

目的 :探索通过甲状腺囊液鉴别甲状腺良、恶性囊肿的临床应用。方法 :分析 5 9例甲状腺囊肿囊液 5项指标 ,并和病理结果相对照。结果 :所有恶性病变囊液都是血性或暗红色 ,良性病变大多为黄绿色。 6例恶性病变有 4例 (6 7% )得到了正确的细胞学诊断。恶性囊液中甲状腺激素 (T3 、T4)水平明显低于良性囊液水平 ,恶性囊液的K 水平显著高于良性囊液。恶性囊液LDH及LDH1水平明显高于良性囊液。结论 :综合考虑囊液颜色、粘滞度、细胞学、甲状腺激素 (T3 、T4)、K 离子浓度、LDH活性 ,特别是LDH1的比例会对甲状腺囊肿良、恶性的鉴别提供更多的有价值的信息。

Analysis of cyst fluid for differentiating the benign or malignant characteristic of thyroid cyst

Objective:To find out an alternative method of determining the benign or malignant character of thyroid cyst.Methods:The color,viscosity,cell,thyroid hormones(T 3?T 4?TSH)concentration,electrolytes and biochemical composition of the cystic fluid were examined in 59 patients with thyroid cyst. Five index were evaluated in determining the benigh or malignate character of thyroid cyst.Results:Almost all malignant lesions had dark red or even bloody cystic fluid.Almost benign lesions had brown or yellowish fluid.Only 4(67%)of the malignant lesions were correctly diagnosed by fine needle aspiration biopsy(FNAB).The mean value of T 3 and T 4 concentration was significantly lower in malignant cystic fluid than that in benign lesions.The mean value of the LDH and isozyme was significantly lower in benign cystic fluid than that in malignant nodules.Conclusion:The combination of multiple variables such as color,thyroid hormone (T 3,T 4), electrolytes,LDH activity(espicially the LDH 1) can provide more valuable data for detecting the feature of thyroid cyst.