【摘要】 目的比较细针穿刺细胞学与细针穿刺洗脱液甲状腺球蛋白测定在分化型甲状腺癌颈淋巴结转移诊断中的作用。方法 47例接受手术治疗的分化型甲状腺癌患者,术中对手术切除的颈淋巴结进行直视下细针穿刺细胞学诊断,并对抽吸物的洗脱液进行甲状腺球蛋白的测定,检测结果与病理结果进行对照。分别计算其诊断的敏感性、特异性及准确性并进行对比分析。结果转移性淋巴结(n=46)中甲状腺球蛋白浓度的中位值为5251 ng/ml (1. 79～408300 ng/ml),阴性淋巴结(n=11)中甲状腺球蛋白浓度的中位值为0. 68 ng/ml (0. 04～125. 4 ng/ml)。细针穿刺细胞学的诊断敏感性、特异性和准确率分别为89. 13%、100%和91. 22%。以100 ng/ml为阳性界值,洗脱液甲状腺球蛋白测定的诊断敏感性、特异性及准确率则分别为93. 48%、90. 90%和92. 98%。结论对于分化型甲状腺癌颈淋巴结转移,细针穿刺洗脱液甲状腺球蛋白测定具有和细针穿刺细胞学相同的诊断效率。更多还原

【Abstract】 Objective To compare the diagnostic values of fine-needle aspiration cytology( FNAC) and thyroglobulin measurement in fine-needle aspiration washout fluid( FNA-Tg) in differentiated thyroid cancer( DTC) cervical lymph node metastasis. Methods 47 differentiated thyroid cancer patients were included in this study. Fine-needle aspirations were performed on cervical lymph nodes which were surgically resected for cytology and measurement of Tg in washout fluid. Results The median value of FNA-Tg in metastatic lymph node( n = 46) was 5177 ng/ml( 1. 79 ～ 408300 ng/ml),while lymph node without metastasis( n = 11) showed a median level of 0. 63 ng/ml( 0. 04 ～ 125. 4 ng/ml). The diagnostic sensitivity,specificity and accuracy of FNAC was 89. 13%,100% and 91. 22% respectively. With the threshold of FNA-Tg level at 100 ng/ml,the diagnostic sensitivity,specificity and accuracy of FNA-Tg was 93. 48%,90. 90% and 92. 98% respectively. Conclusion FNA-Tg showed a comparable effectiveness to FNAC for the diagnosis of DTC cervical lymph node metastasis.更多还原