甲状腺癌颈部淋巴结转移区域的超声特点研究

目的：探究甲状腺癌颈部淋巴结转移区域的超声特点。方法回顾性分析58例甲状腺癌患者的临床资料。将患者术前颈部淋巴结转移区域的超声诊断与患者的病理诊断进行比较，分析其超声表现的特点。结果58例患者中经术前超声诊断显示，有36例（62．07％）颈部淋巴结转移，其中3例单纯中央区淋巴结转移、18例单纯颈侧区淋巴结转移、15例颈侧区合并中央区淋巴结转移；中央区淋巴结转移率为31．03％，显著低于颈侧区淋巴结转移率56．89％。病理诊断结果显示，58例患者中有33例（56．89％）颈部淋巴结转移，其中21例单纯中央区淋巴结转移，2例单纯颈侧区淋巴结转移，10例颈侧区合并中央区淋巴结转移；中央区淋巴结转移率为53．44％，显著高于颈侧区淋巴结转移率20．68％。超声诊断颈部转移性淋巴结的特异性为80．0％（12／15），敏感性为100．0％（33／33）。超声检查对中央区转移性淋巴结的检出率为58．06％（18／31），显著低于颈侧区转移性淋巴结的检出率100．0％（12／12）。超声诊断颈侧区淋巴结转移与病理结果的符合率为36．36％（12／33），显著低于中央区淋巴结转移与病理结果的符合率58．06％（18／31），差异具有统计学意义（P＜0．05）。颈侧区和中央区中淋巴门回声消失和低回声占较高的比例，且颈侧区和中央区颈侧区转移性淋巴结中L／T＜2所占的比例差异具有统计学意义（P＜0．05）。结论甲状腺癌多转移至颈部中央区淋巴结，采用超声检查具有较高的特异性，对中央区淋巴结的诊断有十分重要的意义。

Study of Ultrasound Features of Thyroid Cancer Lymph Node Metastasis Area

Objective To explore the ultrasound features of thyroid cancer lymph node metastasis area .Methods A retrospective analysis of clinical data of 58 cases of thyroid cancer patients were conducted .The preoperative diagnosis of thyroid cancer lymph node metastasis area and pathological diagnosis were compared , and the performance characteristics of the ultra-sound was analyzed .Results 58 patients before surgery by ultrasound diagnosis showed that 36 (62.07%) patients had cervical lymph node metastasis ,3 cases of simple central lymph node metastasis ,18 cases of simple lateral neck lymph node metastasis ,15 cases of lateral neck merger central lymph node metastasis ,the central lymph node metastasis 31.03% was significantly lower than lateral neck lymph node metastasis rate of 56.89%.Pathology results showed that among 58 patients,33(56.89%) patients had cervical lymph node metastasis ,21 cases of simple central lymph node metastases ,2 cases of simple lateral neck lymph node metastasis,10 cases of lateral neck merger central lymph node metastasis ,the central lymph node metastasis rate was 53.44%, which was significantly higher than the lateral neck lymph node metastasis rate of 20.68%.Ultrasound diagnosis of metastatic lymph nodes in the neck and a specificity of 80.00%(12/15),with a sensitivity of 100.0%(33/33).Ultrasound examination of the central region of metastatic lymph node detection rate of 58.06%(18/31) was significantly lower than the base of the throat area of metastatic lymph node detection rate of 100.0%(12/12),ultrasound diagnostic lateral neck lymph node metastasis and pathological results coincidence rate was 36.36%(12/33),which was significantly lower than central lymph node metastasis and pathological findings consistent rate of 58.06%(18/31).The difference was statistically significant (P<0.05).Lateral neck re-gion and the central region of lymph door hypoechoic echo disappears had the highest proportion .And lateral neck and central area of metastatic lymph nodes in the lateral neck area L /T<2 proportion of the difference was statistically significance (P<0.05). Conclusion Thyroid cancer metastasis to the central neck lymph nodes ,using ultrasound has a high specificity ,and is very im-portant for the diagnosis of central lymph node .