超声引导下细针穿刺细胞学及穿刺冲洗液甲状腺球蛋白检测对甲状腺乳头状癌颈部淋巴结转移的诊断价值

Q4 Medicine

肿瘤研究与临床 Pub Date : 2019-10-28 DOI:10.3760/CMA.J.ISSN.1006-9801.2019.10.007

Haifeng Gao, Qiujian Zhao, Ziying Gao, N. Ma

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Histopathological examination showed 220 lymph node metastases were positive, 62 were negative. FNAC examination showed 193 lymph nodes were positive and 89 were negative. The sensitivity, specificity, Youden index, positive predictive value, negative predictive value, accuracy of FNAC for diagnosing the lymph nodes of metastasis PTC was 84.55%, 88.71%, 73.26%, 96.37%, 61.80%, 85.46%, respectively. FNA-Tg test showed that 198 lymph nodes were diagnosed as positive metastasis and 84 were negative metastasis. The sensitivity, specificity, Youden index, positive predictive value, negative predictive value, accuracy of FNA-Tg for diagnosing the lymph nodes of metastasis PTC was 88.64%, 95.16%, 83.80%, 98.48%, 70.24%, 90.07%, respectively. Both FNAC and FNA-Tg test showed 215 lymph nodes were diagnosed as positive metastasis and 76 were negative metastasis. 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引用次数: 0

摘要

目的探讨超声引导下细针穿刺细胞学（FNAC）和细针穿刺冲洗液甲状腺球蛋白（FNA-Tg）检测对甲状腺乳头状癌（PTC）颈淋巴结转移的诊断价值。方法收集2015年8月至2018年10月在宝鸡市中心医院经病理活检确诊的PTC患者214例，均在超声引导下进行FNAC，并采用电化学发光免疫法测定FNA-Tg。对淋巴结清扫术后所有可疑淋巴结进行组织病理学检查，并对结果进行统计学分析。结果214例PTC患者中检出可疑肿大淋巴结282例。组织病理学检查显示220例淋巴结转移呈阳性，62例呈阴性。FNAC检查显示193个淋巴结阳性，89个淋巴结阴性。FNAC诊断转移性PTC淋巴结的敏感性、特异性、Youden指数、阳性预测值、阴性预测值、准确性分别为84.55%、88.71%、73.26%、96.37%、61.80%、85.46%。FNA-Tg检查显示198个淋巴结被诊断为阳性转移，84个淋巴结为阴性转移。FNA-Tg诊断转移性PTC淋巴结的敏感性、特异性、Youden指数、阳性预测值、阴性预测值和准确性分别为88.64%、95.16%、83.80%、98.48%、70.24%和90.07%。FNAC和FNA-Tg检查均显示215个淋巴结被诊断为阳性转移，76个淋巴结为阴性转移。联合治疗的敏感性、特异性、优登指数、阳性预测值、阴性预测值、准确性分别为97.63%、87.32%、84.95%、95.81%、92.54%、96.81%。联合检测的灵敏度和准确性均高于单一检测，差异有统计学意义（均P<0.05）。结论FNAC和FNA-Tg检测简便、安全、准确。FNAC和FNA-Tg联合检测可提高PTC淋巴结转移诊断的敏感性和准确性。关键词：甲状腺肿瘤；癌，乳头状；淋巴结转移；活检，细针；冲洗液；甲状腺球蛋白

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Diagnostic value of ultrasound-guided fine-needle aspiration cytology and thyroglobulin detection in aspiration washout fluid for neck lymph nodes metastasis in patients with papillary thyroid carcinoma

Objective To investigate the diagnostic value of ultrasound-guided fine-needle aspiration cytology (FNAC) and fine-needle aspiration washout fluid thyroglobulin (FNA-Tg) detection for neck lymph nodes metastasis in patients with papillary thyroid carcinoma (PTC). Methods A total of 214 PTC patients confirmed by pathology biopsy in Baoji Central Hospital from August 2015 to October 2018 were collected, and they all underwent ultrasound-guided FNAC, and FNA-Tg was measured by using electrochemiluminescence immunoassay. The histopathologic detection was performed for all suspicious lymph nodes after lymphadenectomy, and the results were analyzed by using statistics. Results There were 282 suspicious enlarged lymph nodes detected from 214 PTC patients. Histopathological examination showed 220 lymph node metastases were positive, 62 were negative. FNAC examination showed 193 lymph nodes were positive and 89 were negative. The sensitivity, specificity, Youden index, positive predictive value, negative predictive value, accuracy of FNAC for diagnosing the lymph nodes of metastasis PTC was 84.55%, 88.71%, 73.26%, 96.37%, 61.80%, 85.46%, respectively. FNA-Tg test showed that 198 lymph nodes were diagnosed as positive metastasis and 84 were negative metastasis. The sensitivity, specificity, Youden index, positive predictive value, negative predictive value, accuracy of FNA-Tg for diagnosing the lymph nodes of metastasis PTC was 88.64%, 95.16%, 83.80%, 98.48%, 70.24%, 90.07%, respectively. Both FNAC and FNA-Tg test showed 215 lymph nodes were diagnosed as positive metastasis and 76 were negative metastasis. The sensitivity, specificity, Youden index, positive predictive value, negative predictive value, accuracy of combined treatments were 97.63%, 87.32%, 84.95%, 95.81%, 92.54%, 96.81%, respectively. The sensitivity and accuracy of combined detection were higher than those of single detection, and there were statistically significant differences (all P < 0.05). Conclusions FNAC and FNA-Tg detection are simple, safe and accurate. The combined detection of FNAC and FNA-Tg can improve the sensitivity and accuracy for the diagnosis of PTC lymph node metastasis. Key words: Thyroid neoplasms; Carcinoma, papillary; Lymph nodes metastasis; Biopsy, fine-needle; Washout fluid; Thyroglobulin

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来源期刊

肿瘤研究与临床 Medicine-Oncology

CiteScore

0.10

自引率

0.00%

发文量

7737

期刊介绍： "Cancer Research and Clinic" is a series of magazines of the Chinese Medical Association under the supervision of the National Health Commission and sponsored by the Chinese Medical Association. It mainly reflects scientific research results and academic trends in the field of malignant tumors. The main columns include monographs, guidelines and consensus, standards and norms, treatises, short treatises, survey reports, reviews, clinical pathology (case) discussions, case reports, etc. The readers are middle- and senior-level medical staff engaged in basic research and clinical work on malignant tumors.