Diagnostic Value of Serum TSH, Ultrasound, and Enhanced CT in Papillary Thyroid Carcinoma with Lymph Node Metastasis

Meiqing He, Xixi Zhang, Hui Li, Tianshu Wang
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Abstract

Objective: To explore the diagnostic value of serum TSH, ultrasound, and enhanced CT in papillary thyroid carcinoma with lymph node metastasis. Methods: 168 patients who underwent thyroidectomy in Shaanxi Provincial People’s Hospital from January 2020 to December 2021 were selected as the research subjects. Based on the pathological nature (benign or malignant), they were divided into two groups, with 86 patients in the control group and 82 patients in the study group. Based on whether the pathology was accompanied with lymph node metastasis, the PTC group was divided into a lymph node metastasis group and a non-lymph node metastasis group, with 51 and 31 patients in the respective groups. Retrospective analysis was conducted to observe and analyze the pathological results of the thyroid nodules’ thyroid ultrasound results, neck enhanced CT results, and thyroid function test serology results. Results: Compared with the PTC group, there were significant differences in TR classification, ultrasonic lymph nodes, and enhanced CT lymph nodes, but no significant differences in the course of disease, nodule distribution, and the number of nodules between the benign nodule group and PTC group; in the comparison of lymph node metastasis using ultrasound and enhanced CT, the number of patients with ultrasound lymph nodes without abnormal metastasis in the non-metastasis group was 28, while that of the metastasis group was 21; the number of patients with abnormal metastasis in the non-metastasis group was 3, while that of the metastasis group was 30. The number of patients with a single node without metastasis and metastasis was 14 and 8, respectively, whereas the number of patients with multiple nodes without metastasis and metastasis was 17 and 43, respectively. There were statistically significant differences in the number of ultrasound lymph nodes and nodules, but no statistically significant differences in TR classification, enhanced CT lymph nodes, nodules distribution, and disease course. Conclusion: Serum TSH can be used to identify the nature (benign and malignant) of thyroid nodules, and enhanced CT is better than ultrasound when evaluating complex lesions. It can be used as a supplement to ultrasound based on clinical context.
血清TSH、超声及增强CT对甲状腺乳头状癌伴淋巴结转移的诊断价值
目的:探讨血清TSH、超声及增强CT对甲状腺乳头状癌伴淋巴结转移的诊断价值。方法:选取2020年1月至2021年12月在陕西省人民医院行甲状腺切除术的168例患者作为研究对象。根据病理性质(良性或恶性)分为两组,对照组86例,研究组82例。根据病理是否伴有淋巴结转移,将PTC组分为淋巴结转移组和非淋巴结转移组,分别有51例和31例患者。回顾性分析观察分析甲状腺结节的甲状腺超声、颈部增强CT、甲状腺功能检查血清学等病理结果。结果:与PTC组比较,良性结节组与PTC组在TR分型、超声淋巴结、增强CT淋巴结等方面差异有统计学意义,但在病程、结节分布、结节数量等方面差异无统计学意义;在超声与增强CT检查淋巴结转移的比较中,无转移组超声淋巴结无异常转移患者28例,转移组21例;非转移组异常转移3例,转移组异常转移30例。单淋巴结无转移者14例,无转移者8例,多淋巴结无转移者17例,无转移者43例。超声淋巴结、结节数量差异有统计学意义,而TR分型、CT增强淋巴结、结节分布、病程差异无统计学意义。结论:血清TSH可用于判断甲状腺结节的性质(良恶性),增强CT对复杂病变的评价优于超声。它可以根据临床情况作为超声的补充。
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