超声检查联合血清学检测对甲状腺乳头状癌侵袭性评估的研究

摘要

目的 探讨超声检查联合血清学检测对甲状腺乳头状癌(papillay thyroid carcinoma, PTC)侵袭性评估的价值.方法 对355例病理确诊为甲状腺乳头状癌的患者分为有淋巴结转移组及无淋巴结转移组, 将两组患者的相关超声特征和血清学检测结果进行相关性分析.结果 1)355例患者术后病理中有颈部淋巴结转移者134例, 无淋巴结转移者221例;2)单因素分析显示甲状腺乳头状癌≥1.5cm、多发病灶、结节内微钙化灶发生颈部淋巴结转移增多(P＜0.05), 以结节内微钙化灶预测更有价值;3)单因素分析显示TSH、TG、TgAb、TPOAb中, TSH、TG水平升高对预测淋巴结转移有较高价值(P＜0.05).结论 超声指标中结节大小、结节数目和结节内微钙化灶与甲状腺乳头状癌侵袭性具有一定的相关性;血清学检测中, TSH、TG对甲状腺乳头状癌的颈部淋巴结转移有一定的预测价值.超声指标联合血清TSH、TG检测在甲状腺乳头状癌颈部淋巴结转移及结节的侵袭性预测中有重要的临床价值.%Objective To study the invasiveness of papillary thyroid carcinoma (PTC) by combination of ultrasonography and serological examination. Methods Three hundred and fifty-five patients of PTC confirmed by pathological examination were divided into two groups: the group with lymphatic metastasis and the other group without lymphatic metastasis. The ultrasonographic characteristics and serological index of both group were analyzed. Results 1) In all the 355 patients, 134 cases were with lymphatic metastasis and 221 cases were without lymphatic metastasis; 2) Some ultrasonographic characteristics including the diameters (D), numbers, micro-calcification were correlated with lymphatic metastasis (P＜0.05), D＞1.5 cm, and multiple focus and micro-calcification were useful characteristics in prediction of invasiveness of PTC; 3) In all the serological index studied including TSH, TG, TGAb and TPOAb, the levels of TSH and TG were correlated with lymphatic metastasis (P＜0.05). Conclusion Some sonographic characteristics and level increasing of TSH and TG were significance to study the lymphatic metastasis of PTC. The combination of ultrasonographic characteristics and serological examination play an important role in prediction of invasiveness of PTC.