Moon Sun Jeong, Kim Dong Wook, Kim Seong Jin, Ha Tae Kwun, Park Ha Kyoung, Jung Soo Jin
Department of Radiology, Inje University College of Medicine, Busan, South Korea.
Department of General Surgery, Inje University College of Medicine, Busan, South Korea.
Endocr Pract. 2014 Oct;20(10):1037-43. doi: 10.4158/EP14016.OR.
This study aimed to assess the diagnostic accuracy of ultrasound (US)-based T staging of papillary thyroid microcarcinoma (PTMC).
From January to June 2013, a total of 185 patients underwent preoperative thyroid US for the treatment of thyroid malignancy. A single radiologist immediately determined sonographic T staging for PTMC during real-time US examination. Based on histopathologic results, the diagnostic accuracy of sonographic T staging for PTMC and the difference in the frequency of level VI node metastasis according to the T stage of PTMC were evaluated.
Of 105 PTMC cases, the preoperative sonographic diagnoses included intraglandular location (n = 35), subcapsular location (n = 30), mild capsule abutment (n = 7), moderate capsule abutment (n = 19), and perithyroidal invasion without adjacent strap muscle invasion (n = 14). When the sonographic T stages were compared with histopathologic results, all the sonographic categories showed high specificity and low sensitivity. The intraglandular and subcapsular location cases in preoperative US diagnosis showed a low rate of extrathyroidal tumor invasion (6.2%, 4/65). The extrathyroidal tumor invasion cases in preoperative US diagnosis only included 26 extrathyroidal fat invasion cases, and 12 (46.2%, 12/26) true positives. There was a significant correlation between multifocality and histopathologic T stage, but no significant relationship between level VI node metastasis and histopathologic T stage was found.
The sonographic T staging categorization described here may be helpful for the preoperative evaluation of PTMC patients.
本研究旨在评估基于超声（US）的甲状腺微小乳头状癌（PTMC）T分期的诊断准确性。
2013年1月至6月，共有185例患者因甲状腺恶性肿瘤接受术前甲状腺超声检查。一名放射科医生在实时超声检查期间立即确定PTMC的超声T分期。根据组织病理学结果，评估PTMC超声T分期的诊断准确性以及PTMC T分期与Ⅵ区淋巴结转移频率的差异。
在105例PTMC病例中，术前超声诊断包括腺内位置（n = 35）、被膜下位置（n = 30）、轻度被膜侵犯（n = 7）、中度被膜侵犯（n = 19）和甲状腺周围侵犯但未侵犯相邻带状肌（n = 14）。将超声T分期与组织病理学结果进行比较时，所有超声分类均显示出高特异性和低敏感性。术前超声诊断为腺内和被膜下位置的病例甲状腺外肿瘤侵犯率较低（6.2%，4/65）。术前超声诊断的甲状腺外肿瘤侵犯病例仅包括26例甲状腺外脂肪侵犯病例，其中12例（46.2%，12/26）为真阳性。多灶性与组织病理学T分期之间存在显著相关性，但未发现Ⅵ区淋巴结转移与组织病理学T分期之间存在显著关系。
本文所述的超声T分期分类可能有助于PTMC患者的术前评估。
