摘要
目的探讨对甲状腺微小乳头状癌患者颈部淋巴结转移进行超声检查评估的临床价值。方法方便选取该院(2015年1月—2017年1月)收治的157例甲状腺微小乳头状癌患者为研究对象,所有患者均经手术后病理证实,记录本组患者手术方式和术后淋巴结转移情况以及超声检查效能。结果术前超声检查淋巴结有无转移的敏感度为38.46%(25/65);特异度为96.63%(86/89);阳性预测值为89.29%(25/28);阴性预测值为68.25%(86/126)。术前超声检查颈侧组淋巴结有无转移的敏感度为80.95%(17/21);特异度为98.50%(131/133);阳性预测值为89.47%(17/19);阴性预测值为97.04%(131/135)。术前超声检查中央组淋巴结有无转移的敏感度为31.67%(19/60);特异度为96.81%(91/94);阳性预测值为86.36%(19/22);阴性预测值为68.94%(91/132)。术前超声检查中央组淋巴结有无转移敏感度为59.09%(13/22);特异度为93.23%(124/133)。8例患者(6.06%)术前超声检查判断中央组淋巴结无转移患者,术后颈侧组淋巴结有转移。4例患者(4.30%)术中病理检查结果显示淋巴结无转移,术后颈侧组淋巴结有转移。结论术前超声检查颈侧组淋巴结有无转移的特异度、敏感度高,中央组淋巴结有无转移敏感度较低。
Objective To evaluate the clinical value of ultrasonography in the evaluation of lymph node metastasis in patients with thyroid micropapillary carcinoma.Methods 157 cases of thyroid micropapillary carcinoma admitted to the hospital from January 2015 to January 2017 were convenient selected as the study subjects.All patients were confirmed by pathology after surgery.The surgical methods and postoperative lymph node metastasis,and ultrasound performance were recorded.Results The sensitivity of preoperative ultrasound examination for lymph node metastasis was 38.46%(25/65);the specificity was 96.63%(86/89);the positive predictive value was 89.29%(25/28);the negative predictive value was 68.25%(86/126).The sensitivity of preoperative ultrasound examination for metastasis of the cervical lymph node was 80.95%(17/21);the specificity was 98.50%(131/133);the positive predictive value was 89.47%(17/19);the negative predictive value was 97.04%(131/135).The sensitivity of preoperative ultrasonography in the detection of lymph node metastasis in the central group was 31.67%(19/60);the specificity was 96.81%(91/94);the positive predictive value was 86.36%(19/22);the negative predictive value was 68.94%(91/132).Preoperative ultrasound examination showed that the metastasis sensitivity of central lymph nodes was 59.09%(13/22)and the specificity was 93.23%(124/133).8 patients(6.06%)had preoperative ultrasonography to judge patients with no lymph node metastasis in the central group and there was metastasis in the cervical lymph nodes after surgery.Intraoperative pathological findings in 4 patients(4.30%)showed no lymph node metastasis and there was metastasis in the cervical lymph nodes after surgery.Conclusion The preoperative ultrasonography has high specificity and sensitivity in the metastasis of the lymph nodes in the cervical region,and the central group has no lymph node metastasis sensitivity.
作者
李奉勇
LI Feng-yong(Department of Ultrasound,Laiwu City Traditional Chinese Medicine Hospital,Laiwu,Shandong Province,271100 China)
出处
《中外医疗》
2018年第23期165-167,共3页
China & Foreign Medical Treatment
关键词
超声检查
甲状腺
微小乳头状癌
颈部
淋巴结转移
临床价值
Ultrasonography
Thyroid
Micropapillary carcinoma
Neck
Lymph node metastasis
Clinical value
作者简介
李奉勇(1968-),男,山东莱芜人,本科,副主任医师,研究方向:超声专业。
