中国肿瘤外科杂志2024，Vol.16Issue(3)：266-270,5.DOI:10.3969/j.issn.1674-4136.2024.03.010
B超、双能CT、细针穿刺在甲状腺乳头状癌术前评估淋巴结转移中的优化选择
The optimal selection of B-ultrasound,dual-energy computed tomography,and fine-needle aspiration for preoperative prediction of lymph node metastases in papillary thyroid carcinoma
摘要
Abstract
Objective To determine the best preoperative diagnostic method for lymph node metastasis(LNM)in thyroid cancer by comparing high-resolution ultrasonography(US),dual-energy computed tomography(DECT),and fine-needle aspiration biopsy(FNAB).Methods The data of 1,174 papillary thyroid carcinoma(PTC)patients treated surgically at the First Affiliated Hospital of Nanjing Medical University was retrospectively analyzed.All patients were assessed preoperatively using US and DECT;One hundred and sixty-seven patients also underwent FNAB with thyroglobulin(TG)testing in washout fluid for LNM evaluation.Postoperative pathology was the diagnostic"gold standard"for assessing the best method to evaluate PTC LNM.Results DECT had a higher sensitivity for predicting LNM than US(55.4％vs 44.8％,P＜0.001),albeit with lower specificity(42.7％vs 72.7％,P＜0.001).When combined together,US and DECT's diagnostic accuracy for CLNM and LLNM varied:higher when findings are consistent but substantially lower when results are inconsistent(75.5％vs.63.4％,P＜0.001).At this time,the accuracy of FNAB and FNA-TG testing in suspicious lymph nodes increased to 87.9％.Conclusions Combining US and DECT is necessary for LNM evaluation;When the combined diagnosis has metastasis,no additional examination is required.When the combined diagnosis results are inconsistent,further FNAB and FNA-TG detection of lymph nodes are required to avoid unnecessary lateral dissection.关键词
甲状腺乳头状癌/高分辨率超声检查/双能计算机断层扫描/细针穿刺抽吸活检/淋巴结转移Key words
Papillary thyroid carcinoma/High-resolution ultrasonography/Dual-energy computed tomography/Fine-needle aspiration biopsy/Lymph node metastasis引用本文复制引用
李琳,张丽君,斯岩,沈美萍..B超、双能CT、细针穿刺在甲状腺乳头状癌术前评估淋巴结转移中的优化选择[J].中国肿瘤外科杂志,2024,16(3):266-270,5.基金项目
江苏省科教能力提升工程(江苏重点学科ZDXK202222) （江苏重点学科ZDXK202222）
