摘要
目的:探讨超声引导下细针穿刺细胞学检查(FNAC)及细针穿刺洗脱液甲状腺球蛋白(FNA-Tg)测定诊断甲状腺乳头状癌淋巴结转移的价值。方法:选择110例甲状腺乳头状癌患者共120枚淋巴结,所有患者均行FNAC、FNA-Tg检测,以病理结果为金标准,绘制ROC曲线,取得FNA-Tg最佳诊断界值,比较FNAC、FNA-Tg及FNAC+FNA-Tg联合应用对甲状腺乳头状癌淋巴结转移的诊断效能。结果:手术病理结果显示,68枚(56.67%)淋巴结发生转移。转移淋巴结的FNA-Tg浓度为[(204.12±98.13)μg/L],高于未转移淋巴结的[(6.26±3.41)μg/L](P<0.001)。ROC曲线获得FNA-Tg最佳界值为2.88μg/L,曲线下面积(95%CI)为0.952(0.930~0.989)。FNAC、FNA-Tg、FNAC+FNA-Tg诊断准确率分别为80.83%、93.33%、95.00%,且FNA-Tg及FNAC+FNA-Tg的诊断效能均高于FNAC(P<0.05)。结论:FNAC+FNA-Tg联合应用有利于提高甲状腺乳头状癌患者淋巴结转移的诊断效能。
Aim:To investigate the value of fine needle aspiration cytology(FNAC) and fine needle aspiration thyroglobulin(FNA-Tg) under ultrasound in the diagnosis of lymph node metastasis of thyroid papillary carcinoma.Methods:A total of 120 lymph nodes were selected from 110 patients with thyroid papillary carcinoma.FNAC and FNA-Tg were performed in all patients.With pathological results as the gold standard, ROC curve was drawn to obtain the best diagnostic threshold of FNA-Tg.The diagnostic efficiency of FNAC,FNA-Tg and FNAC+FNA-Tg combination on lymph node metastasis of thyroid papillary carcinoma was compared.Results:The surgical pathology report showed that 68 lymph nodes(56.67%) had metastasis.The concentration of FNA-Tg in metastatic lymph nodes was[(204.12±98.13) μg/L],which was higher than that in non-metastatic lymph nodes[(6.26±3.41) μg/L](P<0.001).The optimal threshold value of FNA-Tg obtained from ROC curve was 2.88 μg/L,and the area under the curve(95%CI) were 0.952(0.930-0.989).The diagnostic accuracy of FNAC,FNA-Tg and FNAC+FNA-Tg was 80.83%,93.33% and 95.00%,respectively, and the diagnostic efficiency of FNA-Tg and FNAC+FNA-Tg were higher than that of FNAC(P<0.05).Conclusion:FNAC+FNA-Tg test is helpful to improve the diagnostic efficiency of lymph node metastasis in patients with thyroid papillary carcinoma.
作者
柴吉鑫
张雪
齐艳涛
陈泳
李波
敖亚洲
CHAI Jixin;ZHANG Xue;QI Yantao;CHEN Yong;LI Bo;AO Yazhou(Department of Thyroid Surgery,the Affiliated Hospital,Chengde Medical College,Chengde,Hebei 067000)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2023年第1期134-137,共4页
Journal of Zhengzhou University(Medical Sciences)
基金
承德市科技计划项目(201801A049)。
关键词
甲状腺乳头状癌
淋巴结转移
细针穿刺
洗脱液甲状腺球蛋白
thyroid papillary carcinoma
lymph node metastasis
fine needle aspiration
thyroglobulin in eluent
