分化型甲状腺癌颈淋巴结转移超声特征及病理类型相关性分析
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摘要
目的了解分化型甲状腺癌患者颈部淋巴结转移的超声特征,并分析其与病理类型的相关性。方法选取100例分化型甲状腺癌患者,并且伴有颈部淋巴结转移;根据病理类型分为甲组、乙组,甲组为50例乳头状甲状腺癌患者,乙组为50例滤泡状甲状腺癌患者。所有患者在手术前进行超声检查,观察甲状腺的病变特征和颈部已转移淋巴结的超声特征,包括边界、大小、内部回声、有无钙化、纵横比、血流、囊变等。并收集患者的临床资料,包括性别、年龄等,对比两组患者超声特征。结果甲组患者平均发病年龄低于乙组患者;两组患者超声特征比较,甲组患者的回声较高、纵横比≤2、钙化较少、血流丰富优于乙组,差异有统计学意义(P <0. 05);而乙组边界较清晰、有淋巴门的较多,囊变较少,优于甲组,差异有统计学意义(P <0. 05)。结论分化型甲状腺癌颈部淋巴结转移的超声特征与病理类型有较强的相关性,为评估治疗效果和预后提供依据。
Objective To investigate the ultrasonographic features of cervical lymph node metastasis in differentiated thyroid cancer patients and to analyze its correlation with pathological types. Methods 100 cases of differentiated thyroid cancer with cervical lymph node metastasis were selected and divided into group A and group B according to pathological types. Group A included 50 cases of papillary thyroid cancer and group B included 50 cases of follicular thyroid cancer. All patients underwent ultrasonography before surgery to observe the features of the thyroid lesions and the ultrasound characteristics of the metastatic lymph nodes in the neck,including borders,size,internal echo,presence or absence of calcification,aspect ratio,blood flow,and cystic degeneration. The clinical data of the patients were collected,including gender,age,etc. The ultrasound characteristics of the 2 groups were compared. Results The average age of patients in group A was lower than that of group B. The ultrasonographic features of group A were higher than those of group B,the difference was statistically significant( P < 0. 05). And the border of group B was clearer,there were more lymph nodes,less cystic change,better than group A,the difference was statistically significant( P < 0. 05). Conclusion The ultrasonographic features of cervical lymph node metastasis in differentiated thyroid carcinoma have a strong correlation with pathological type,and provide the basis for assessing therapeutic effect and prognosis.
Objective To investigate the ultrasonographic features of cervical lymph node metastasis in differentiated thyroid cancer patients and to analyze its correlation with pathological types. Methods 100 cases of differentiated thyroid cancer with cervical lymph node metastasis were selected and divided into group A and group B according to pathological types. Group A included 50 cases of papillary thyroid cancer and group B included 50 cases of follicular thyroid cancer. All patients underwent ultrasonography before surgery to observe the features of the thyroid lesions and the ultrasound characteristics of the metastatic lymph nodes in the neck,including borders,size,internal echo,presence or absence of calcification,aspect ratio,blood flow,and cystic degeneration. The clinical data of the patients were collected,including gender,age,etc. The ultrasound characteristics of the 2 groups were compared. Results The average age of patients in group A was lower than that of group B. The ultrasonographic features of group A were higher than those of group B,the difference was statistically significant( P < 0. 05). And the border of group B was clearer,there were more lymph nodes,less cystic change,better than group A,the difference was statistically significant( P < 0. 05). Conclusion The ultrasonographic features of cervical lymph node metastasis in differentiated thyroid carcinoma have a strong correlation with pathological type,and provide the basis for assessing therapeutic effect and prognosis.
引文
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[10]毕腾云,白文坤,胡兵.甲状腺超声钙化形态与甲状腺癌的关系〔J〕.中国超声医学杂志,2016,32(6):481-483.
[11]孟君,杨高怡,闻波平,等.钙化灶在颈部结核性淋巴结与甲状腺乳头状癌转移性淋巴结中的超声特征〔J〕.中国超声医学杂志,2015,31(6):487-489.
[12]周琦,李诗骜,姜珏,等.超声造影鉴别甲状腺钙化结节性质及其与年龄、性别的相关性分析〔J〕.中华超声影像学杂志,2016,25(4):313-317.
[13] Qiao SF,Zheng XK,Wang P,et al. Multivariate regression analysis of factors related to lymph node metastasis in moderately differentiated tubular adenocarcinoma of rectum〔J〕. China J Modern Med,2015,12(4):755-759.
[14] Takumi K,Fukukura Y,Higashi M,et al. Pancreatic neuroendocrine tumors:Correlation between the contrast-enhanced computed tomography features and the pathological tumor grade〔J〕. Eur J Radiol,2015,84(8):1436-1442.
[15] Lai CW,Duh QY,Chen CW,et al. VEGF-D and A Preoperative Serum Levels Predict Nodal and Distant Metastases in Differentiated Thyroid Cancer Patients〔J〕. World J Surg,2015,39(7):1742-1749.
[16]夏亮,陆涤宇,周俊,等. 131I-SPECT/CT多模态显像联合超声及血清Tg对分化型甲状腺癌颈部淋巴结转移的诊断价值〔J〕.肿瘤学杂志,2017,23(4):278-281.
[2]赵博,胡静,王金锐,等.分化型甲状腺癌临床及超声特征与颈部淋巴结转移的相关性分析〔J〕.中国超声医学杂志,2017,33(6):13-16.
[3]丁珂,严昆.超声对预测甲状腺乳头状癌颈部淋巴结转移的研究进展〔J〕.中国临床医学影像杂志,2016,27(9):663-666.
[4]陈伟,纪晓惠,韩若凌,等.常规超声和增强CT对诊断甲状腺癌中央区淋巴结转移的价值〔J〕.中华超声影像学杂志,2015,24(8):722-723.
[5] Silvavieira M,Santos R,Leite V,et al. Review of clinical and pathological features of 93 cases of well-differentiated thyroid carcinoma in pediatric age at the lisbon centre of the portuguese institute of oncology between 1964 and 2006〔J〕. Int J Pediatr Otorhinolaryngol,2015,79(8):1324-1329.
[6]刘静静,刘利平.甲状腺癌的超声诊断及新技术的临床应用进展〔J〕.中华超声影像学杂志,2015,24(2):181-183.
[7] Liu LS,Wei ZX,Jun-Hong LI,et al. Analysis of risk factors of lung metastasis in elderly patients with differentiated thyroid carcinoma〔J〕. Labeled Immunoassays&Clinical Medicine,2016,10(6):357-361.
[8]丁玫,冯先瑞,闫媛媛,等.不同年龄结节性甲状腺肿合并甲状腺癌患者甲状腺超声特征比较〔J〕.山东医药,2016,56(14):66-67.
[9]石文媛,胡敏霞,朱强,等.甲状腺乳头状癌伴颈部淋巴结转移的超声征象分析〔J〕.中华医学杂志,2016,96(27):2165-2168.
[10]毕腾云,白文坤,胡兵.甲状腺超声钙化形态与甲状腺癌的关系〔J〕.中国超声医学杂志,2016,32(6):481-483.
[11]孟君,杨高怡,闻波平,等.钙化灶在颈部结核性淋巴结与甲状腺乳头状癌转移性淋巴结中的超声特征〔J〕.中国超声医学杂志,2015,31(6):487-489.
[12]周琦,李诗骜,姜珏,等.超声造影鉴别甲状腺钙化结节性质及其与年龄、性别的相关性分析〔J〕.中华超声影像学杂志,2016,25(4):313-317.
[13] Qiao SF,Zheng XK,Wang P,et al. Multivariate regression analysis of factors related to lymph node metastasis in moderately differentiated tubular adenocarcinoma of rectum〔J〕. China J Modern Med,2015,12(4):755-759.
[14] Takumi K,Fukukura Y,Higashi M,et al. Pancreatic neuroendocrine tumors:Correlation between the contrast-enhanced computed tomography features and the pathological tumor grade〔J〕. Eur J Radiol,2015,84(8):1436-1442.
[15] Lai CW,Duh QY,Chen CW,et al. VEGF-D and A Preoperative Serum Levels Predict Nodal and Distant Metastases in Differentiated Thyroid Cancer Patients〔J〕. World J Surg,2015,39(7):1742-1749.
[16]夏亮,陆涤宇,周俊,等. 131I-SPECT/CT多模态显像联合超声及血清Tg对分化型甲状腺癌颈部淋巴结转移的诊断价值〔J〕.肿瘤学杂志,2017,23(4):278-281.