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超声引导下细针穿刺细胞学检查联合甲状腺过氧化物酶及甲状腺球蛋白抗体在评估甲状腺癌颈部淋巴结转移中的作用

Role of ultrasound‑guided fine‑needle aspiration cytology combined with thyroid peroxidase and thyroglobulin antibodies in evaluating cervical lymph node metastasis in thyroid cancer.

作者信息

Weng Lifeng

机构信息

Department of Ultrasound Medicine, Nanjing Medical University Affiliated Changzhou Second People's Hospital, Changzhou, Jiangsu 213004, P.R. China.

出版信息

Oncol Lett. 2024 Aug 27;28(5):512. doi: 10.3892/ol.2024.14645. eCollection 2024 Nov.

Abstract

The present study was designed to explore the role of ultrasound-guided fine-needle aspiration (FNA) cytology combined with thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (Tg-Ab) in evaluating cervical lymph node metastasis in thyroid cancer. The aim was to propose more effective diagnostic strategies for cervical lymph node metastasis in patients with thyroid cancer. Firstly, the present retrospective case-control study selected 294 patients with thyroid cancer treated at Changzhou Second People's Hospital (Changzhou, China). High-resolution ultrasound equipment was used for ultrasound and FNA examinations. Additionally, a retrospective analysis of the patient's comprehensive thyroid function tests, including TPO-Ab and Tg-Ab levels, was conducted. Subsequently, univariate and multivariate logistic regression models were employed to analyze the association between various factors and cervical lymph node metastasis. The overall diagnostic accuracy of the model was evaluated using the receiver operating characteristic curve and its area under the curve. Finally, the performance of the diagnostic model was quantitatively assessed through calculating sensitivity, specificity, positive predictive and negative predictive values. According to the experimental results, sex, tumor stage and the levels of thyroid autoantibodies were associated with the risk of cervical lymph node metastasis in thyroid cancer. Moreover, ultrasound features, such as cystic lesions, loss of hilum of the lymph nodes, abundant vascular supply, heterogeneous echo and microcalcification were also closely related to cervical lymph node metastasis. Logistic regression analysis also showed that tumor stage, serum levels of TPO-Ab and Tg-Ab, and cystic lesions were independent predictors of cervical lymph node metastasis. Furthermore, the combined use of ultrasound, FNA, TPO-Ab and Tg-Ab significantly improved diagnostic sensitivity and specificity. Overall, ultrasound-guided FNA combined with TPO-Ab and Tg-Ab may have a significant role in the evaluation of cervical lymph node metastasis in thyroid cancer. This combined diagnostic approach could significantly enhance diagnostic accuracy, providing a more effective strategy for the clinical management of cervical lymph node metastasis in thyroid cancer.

摘要

本研究旨在探讨超声引导下细针穿刺(FNA)细胞学检查联合甲状腺过氧化物酶抗体(TPO-Ab)和甲状腺球蛋白抗体(Tg-Ab)在评估甲状腺癌颈部淋巴结转移中的作用。目的是为甲状腺癌患者颈部淋巴结转移提出更有效的诊断策略。首先,本回顾性病例对照研究选取了在常州市第二人民医院(中国常州)接受治疗的294例甲状腺癌患者。使用高分辨率超声设备进行超声和FNA检查。此外,对患者的综合甲状腺功能检查进行回顾性分析,包括TPO-Ab和Tg-Ab水平。随后,采用单因素和多因素逻辑回归模型分析各种因素与颈部淋巴结转移之间的关联。使用受试者工作特征曲线及其曲线下面积评估模型的总体诊断准确性。最后,通过计算敏感性、特异性、阳性预测值和阴性预测值对诊断模型的性能进行定量评估。根据实验结果,性别、肿瘤分期和甲状腺自身抗体水平与甲状腺癌颈部淋巴结转移风险相关。此外,超声特征,如囊性病变、淋巴结门部消失、丰富的血管供应、不均匀回声和微钙化也与颈部淋巴结转移密切相关。逻辑回归分析还表明,肿瘤分期、血清TPO-Ab和Tg-Ab水平以及囊性病变是颈部淋巴结转移的独立预测因素。此外,超声、FNA、TPO-Ab和Tg-Ab的联合使用显著提高了诊断敏感性和特异性。总体而言,超声引导下FNA联合TPO-Ab和Tg-Ab在评估甲状腺癌颈部淋巴结转移中可能具有重要作用。这种联合诊断方法可以显著提高诊断准确性,为甲状腺癌颈部淋巴结转移的临床管理提供更有效的策略。

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