Antonelli A, Miccoli P, Ferdeghini M, Di Coscio G, Alberti B, Iacconi P, Baldi V, Fallahi P, Baschieri L
Institute of Clinical Medicine II, University of Pisa, Italy.
Thyroid. 1995 Feb;5(1):25-8. doi: 10.1089/thy.1995.5.25.
The aim of the study was to evaluate the role of neck ultrasonography in follow-up of patients with differentiated thyroid cancer. Sixty-three patients had total thyroidectomy and 131I ablation for differentiated thyroid cancer and had a negative whole body scan during follow-up. They were admitted for a high resolution neck ultrasound examination. Sixteen of 63 patients presented images suspicious for lymph node metastasis and/or for local recurrences (4 cases). Fine needle aspiration confirmed the suspicion of malignancy in 12 patients: only lymph node metastasis in 8 cases, local recurrence and lymph node metastasis in 3 cases, and in one case only local recurrence. Fine needle aspiration was suspicious for lymphadenitis in 4 cases. Thyroglobulin levels were very high in all patients with local recurrence and/or lymph node metastasis but undetectable in 2 cases presenting node metastasis and in 4 cases with lymphadenitis. All but one patient were admitted for surgery and the cytological diagnosis was confirmed. Early identification of a pathologic mass in the neck is a desirable goal; high resolution echography can play an important role in the follow-up of these patients and can detect local recurrences even when there is a negative whole body scan or undetectable thyroglobulin level.
本研究的目的是评估颈部超声检查在分化型甲状腺癌患者随访中的作用。63例患者因分化型甲状腺癌接受了甲状腺全切术及¹³¹I消融治疗，且在随访期间全身扫描结果为阴性。他们入院接受了高分辨率颈部超声检查。63例患者中有16例出现可疑淋巴结转移和/或局部复发的图像（4例）。细针穿刺活检证实12例患者存在恶性肿瘤怀疑：8例仅为淋巴结转移，3例为局部复发合并淋巴结转移，1例仅为局部复发。4例细针穿刺活检怀疑为淋巴结炎。所有局部复发和/或淋巴结转移患者的甲状腺球蛋白水平都非常高，但2例出现淋巴结转移的患者及4例淋巴结炎患者的甲状腺球蛋白水平检测不到。除1例患者外，所有患者均入院接受手术，细胞学诊断得到证实。早期发现颈部病理性肿块是一个理想的目标；高分辨率超声检查在这些患者的随访中可发挥重要作用，即使在全身扫描结果为阴性或甲状腺球蛋白水平检测不到时，也能检测到局部复发。
