细针穿刺抽吸物洗脱液中甲状腺球蛋白检测用于诊断甲状腺乳头状癌转移的颈部淋巴结情况
Cervical lymph node thyroglobulin measurement in washout of fine-needle aspirates for diagnosis of papillary thyroid cancer metastases.
作者信息
Li Jiansheng, Zhang Kejun, Liu Xishuang, Hao Fengyun, Liu Ziming, Wang Zhibin
机构信息
a Department of Diagnostic Ultrasound , The Affiliated Hospital of Qingdao University , Qingdao , China.
b Department of Thyroid surgery , The Affiliated Hospital of Qingdao University , Qingdao , China.
出版信息
Br J Biomed Sci. 2016;73(2):79-83. doi: 10.1080/09674845.2016.1173334. Epub 2016 May 11.
BACKGROUND
Patients with papillary thyroid cancer (PTC) and enlarged cervical lymph nodes (CLNs) are usually assessed by fine-needle aspiration biopsy cytology (FNAB-C). Thyroglobulin (Tg) is frequently detected in washout of fine-needle aspirates (FNA) of these lymph nodes. The aim of this study was to evaluate the accuracy of the measurement of FNAB-Tg in the washout of FNAB in combination with FNAB-C to detect CLN metastases in PTC.
METHODS
We retrospectively evaluated 163 surgically proven CLNs. Ultrasound-guided FNAB-C and FNAB-Tg measurements were performed and the ultrasound features were evaluated.
RESULTS
The sensitivity, specificity and accuracy of FNAB-C, FNAB-Tg and FNAB-C/FNAB-Tg in diagnosis of metastatic CLNs were 85.7, 87.8 and 71.6%, were 80.5, 87 and 82.8% and were 97.1, 96.3 and 95.7%, respectively. The diagnostic sensitivity, specificity and accuracy of FNAB-C/FNAB-Tg for metastatic CLNs was significantly higher than that of FNAB-C or FNAB-Tg alone (p < 0.01).
CONCLUSION
Combined US-guided FNAB-C and FNAB-Tg can improve the accuracy for diagnosis of metastatic CLNs in patients with PTC.
背景
甲状腺乳头状癌（PTC）合并颈部淋巴结（CLN）肿大的患者通常通过细针穿刺活检细胞学检查（FNAB-C）进行评估。在这些淋巴结的细针穿刺冲洗液中经常检测到甲状腺球蛋白（Tg）。本研究的目的是评估FNAB冲洗液中FNAB-Tg测量结合FNAB-C检测PTC中CLN转移的准确性。
方法
我们回顾性评估了163个经手术证实的CLN。进行了超声引导下的FNAB-C和FNAB-Tg测量，并评估了超声特征。
结果
FNAB-C、FNAB-Tg和FNAB-C/FNAB-Tg诊断转移性CLN的敏感性、特异性和准确性分别为85.7%、87.8%和71.6%，80.5%、87%和82.8%，以及97.1%、96.3%和95.7%。FNAB-C/FNAB-Tg诊断转移性CLN的敏感性、特异性和准确性显著高于单独的FNAB-C或FNAB-Tg（p<0.01）。
结论
联合超声引导下的FNAB-C和FNAB-Tg可提高PTC患者转移性CLN的诊断准确性。
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