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术中超声检查在分化型甲状腺癌颈部转移灶的外科治疗中具有重要作用。

Intraoperative ultrasonography is useful in surgical management of neck metastases in differentiated thyroid cancers.

作者信息

Ertas Burak, Kaya Hakan, Kurtulmus Neslihan, Yakupoglu Abdullah, Giray Serdar, Unal Omer Faruk, Duren Mete

机构信息

Department of Otorhinolaryngology, Acibadem Maslak Hospital, Istanbul, Turkey.

出版信息

Endocrine. 2015 Feb;48(1):248-53. doi: 10.1007/s12020-014-0287-x. Epub 2014 May 27.

Abstract

Differentiated thyroid carcinomas are the most common malignancies of endocrine organs. Metastases to cervical lymph nodes occur in 20-50% of cases. Recurrence and survival rates are closely related to the type of surgery performed. High-resolution ultrasonography (USG) is a sensitive imaging method used to detect occult lymph node metastases in patients with thyroid cancer. We evaluated how intraoperative USG affected surgical success. This was a retrospective study comparing two groups of patients with thyroid carcinoma who underwent cervical lymph node dissection. A total of 101 patients (33 males and 68 females) were included. Group 1 included 53 patients who underwent surgery with intraoperative USG guidance. Group 2 included 48 patients who underwent surgery without the use of USG. All patients were followed up (mean 23 months; range 5-44 months) with thyroglobulin measurements and USG evaluations. Group 1 (intraoperative USG) had a residual/recurrent tumor rate of 1.9% (1/53 patients). Group 2 had a residual/recurrent tumor rate of 12.5% (6/48 patients). A statistically significant difference appeared between the residual/recurrent tumor rates in Groups 1 and 2 (p<0.05). In addition to its classical use in diagnosis and follow-up, intraoperative use of high-resolution USG can improve surgical success and may decrease the number of residual/recurrent tumors encountered during follow-up.

摘要

分化型甲状腺癌是内分泌器官最常见的恶性肿瘤。20%至50%的病例会出现颈部淋巴结转移。复发率和生存率与所施行的手术类型密切相关。高分辨率超声检查(USG)是一种用于检测甲状腺癌患者隐匿性淋巴结转移的敏感成像方法。我们评估了术中超声检查如何影响手术成功率。这是一项回顾性研究,比较了两组接受颈部淋巴结清扫术的甲状腺癌患者。共纳入101例患者(33例男性和68例女性)。第1组包括53例在术中超声引导下进行手术的患者。第2组包括48例未使用超声进行手术的患者。所有患者均通过甲状腺球蛋白测量和超声评估进行随访(平均23个月;范围5至44个月)。第1组(术中超声检查)的残余/复发肿瘤率为1.9%(53例患者中的1例)。第2组的残余/复发肿瘤率为12.5%(48例患者中的6例)。第1组和第2组的残余/复发肿瘤率之间存在统计学显著差异(p<0.05)。除了在诊断和随访中的传统应用外,术中使用高分辨率超声检查可以提高手术成功率,并可能减少随访期间遇到的残余/复发肿瘤数量。

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