诊断学理论与实践

诊断学理论与实践 ›› 2021, Vol. 20 ›› Issue (04): 367-371.doi: 10.16150/j.1671-2870.2021.04.007

• 论著 • 上一篇    下一篇

负压细针抽吸和毛细抽吸活检法穿刺洗脱液中甲状腺球蛋白测定在甲状腺乳头状癌淋巴结转移中的诊断价值比较

况李君1, 陶玲玲1, 詹维伟2, 李伟伟1, 樊金芳1, 周伟1,2()   

  1. 1.上海交通大学医学院附属瑞金医院卢湾分院超声科,上海 200020
    2.上海交通大学医学院附属瑞金医院超声科,上海 200025
  • 收稿日期:2021-04-06 出版日期:2021-08-25 发布日期:2022-06-28
  • 通讯作者: 周伟 E-mail:zw11468@126.com
  • 基金资助:
    上海市黄浦区科研项目(HKM201801)

Comparison of the diagnostic value of thyroglobulin measurement in needle washouts by FNAC and by FNCC for detecting node metastases in thyroid papillary carcinoma

KUANG Lijun1, TAO Lingling1, ZHAN Weiwei2, LI Weiwei1, FAN Jinfang1, ZHOU Wei1,2()   

  1. 1. Department of Ultrasound, RuiJin Hospital/Lu Wan Branch, School of Medicine, Shanghai Jiao Tong University, Shanghai 200020, China
    2. Department of Ultrasound, RuiJin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China
  • Received:2021-04-06 Online:2021-08-25 Published:2022-06-28
  • Contact: ZHOU Wei E-mail:zw11468@126.com

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摘要：

目的：比较超声引导下负压细针抽吸细胞学（fine needle aspiration cytology, FNAC）和细针毛细法细胞学（fine-needle capillary cytology, FNCC）技术穿刺洗脱液甲状腺球蛋白（thyroglobulin,Tg）测定在诊断甲状腺乳头状癌（papillary thyroid carcinoma,PTC）颈部转移性淋巴结中的价值。 方法：选取2018年1月至2018年12月间我院收治的54例PTC可疑淋巴结转移患者,均接受超声引导下FNAC和FNCC检查,并进行洗脱液Tg测定。最终以手术病理及临床随访结果作为金标准,对比2种方法的诊断效能差异。 结果：54例PTC可疑淋巴结转移患者,共穿刺淋巴结76个,经病理证实为转移淋巴结有48个。采用FNAC与FNCC获得的洗脱液Tg平均值分别为（4 588.02±1 042.09） ng/mL、（1 678.57±420.57） ng/mL,两者间差异有统计学意义（P=0.010 6）;FNAC与FNCC法获取的Tg值诊断转移淋巴结的受试者操作特征（receiver operating characteristic,ROC）曲线下面积分别为0.943、0.913,差异有统计学意义（P=0.032）。FNAC法获取Tg诊断PTC淋巴结转移的最佳临界值为14.385 ng/mL,诊断灵敏度为93.%8,特异度为89.3%;FNCC法获取Tg诊断PTC淋巴结转移的最佳临界值为12.155 ng/mL,诊断灵敏度为87.5%,特异度为89.3%。 结论：FNAC与FNCC均可用于洗脱液Tg测定,均有助于PTC转移性淋巴结的诊断,但与FNCC相比,FNAC更具有诊断优势。

关键词: 细针穿刺细胞学检查, 甲状腺球蛋白, 甲状腺乳头状癌, 转移性淋巴结

Abstract:

Objective: To compare the value of thyroglobulin(Tg) measurement by fine needle aspiration and by fine needle capillary techniques for diagnosing node metastases from thyroid papillary carcinoma(PTC). Methods: Fifty-four patients with suspicious metastatic lymph nodes from PTC were enrolled during January 2018 to December 2018. Ultrasound guided fine needle aspiration cytology(FNAC) and fine needle capillary cytology(FNCC) were performed for detecting suspicious lymph nodes, and the level of Tg in the eluent was measured. According to the post-operative pathologic results and clinical follow-up results, the difference of diagnostic efficacy between the two groups was compared. Results: A total of 76 suspicious lymph nodes were examined, and 48 of them were confirmed as metastasis by pathology. The mean level of Tg in needle washouts by FNAC and by FNCC were （4 588.02±1 042.09） ng/mL and (1 678.57±420.57) ng/mL (P=0.010 6), respectively. The area under receiver operating characteristic curve of Tg value in washouts by FNAC and by FNCC were 0.943 and 0.913, respectively. The difference was significant between methods (P=0.032). The cut-off value of Tg in FNAC group was 14.385 ng/mL, and the diagnostic sensitivity and specificity were 0.938 and 0.893, respectively. The cut-off value of Tg in FNCC group was 12.155 ng/mL, and the diagnostic sensitivity and specificity were 0.875 and 0.893, respectively. Conclusions: Both measurement of Tg in the eluent by FNCC and by FNAC are helpful to the diagnosis of metastatic lymph nodes from PTC. However, FNAC had more advantage over FNCC in diagnosing metastatic lymph nodes.

Key words: Fine needle aspiration cytology, Thyroglobulin, Papillary thyroid carcinoma, Metastatic lymph node

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