| 摘要: |
| 目的 探讨超声联合胸部X线评估甲状腺癌TNM分期的临床应用价值。方法 回顾性分析我院508例甲状腺癌患者的临床资料，术前均行甲状腺、颈部淋巴结、腹部超声常规检查和胸部X线片检查，并对甲状腺结节进行术前临床TNM 分期评估，以术后临床病理结果为金标准，比较术前超声联合胸部X线与术后临床病理TNM分期的一致性及准确率。结果 超声诊断甲状腺癌 T1a、T1b、T2、T3a、T3b、T4b分期的准确率分别为96.43%、83.33%、80.00% 、45.00% 、20.00%、100%，总准确率为79.13%，与术后临床病理结果的一致性较好（Kappa=0.697，P=0.000）。超声诊断甲状腺癌N0、N1a、N1b、N1分期的准确率分别为60.55%、33.33%、39.39%、53.57%，总准确率为54.53%，与术后临床病理结果的一致性差（Kappa=0.244，P=0.000）。超声联合胸部X线片诊断甲状腺癌M0、M1分期的准确率分别为99.60%、100.0% ，总准确率为99.61% ，与术后临床病理结果的一致性较好（Kappa=0.665，P=0.000）。结论 超声诊断甲状腺癌T、N分期的总准确率较高，联合胸部X线对甲状腺癌M分期的准确率最高，有助于临床治疗方案的选择及疗效评估。 |
| 关键词: 超声检查 胸部X线 甲状腺癌 TNM 分期 |
| DOI： |
| 投稿时间：2021-01-12修订日期：2021-08-18 |
| 基金项目:四川省科技厅重点研发项目(2020YFS0406):超声评估甲状腺TNM分期的临床应用研究。 |
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| Clinical application study on TNM staging of thyroid carcinoma by Ultrasonography combined with Chest X-ray |
| liangyu,tanli,wenyi,wangyong,leiju,zhanghui |
| () |
| Abstract: |
| Objective To explore the clinical value of ultrasonography combined with chest x-ray in evaluating TNM staging of thyroid carcinoma.Methods The clinical data of 508 cases of thyroid carcinoma in our hospital from September 2018 to January 2020 were analyzed retrospectively.Thyroid，cervical lymph nodes，abdominal ultrasonography and chest x-ray were examined before operation，and thyroid nodules were evaluated by TNM before operation.According to the results of postoperative clinicopathological TNM staging as the gold standard，the consistency and accuracy of preoperative ultrasonography combined with chest x-ray and postoperative clinicopathological TNM staging were compared.Results The accuracy of ultrasonography in T1a, T1b, T2, T3a, T3b, T4b staging of thyroid carcinoma was 96.43%，83.33%，80.00%，45.00%，20.00% and 100%，respectively,the total accuracy was 79.13%, better consistent with postoperative clinicopathologic results (Kappa=0.697,P=0.000).The accuracy of ultrasonography in N0,N1a,N1b,N1 staging of thyroid carcinoma was 60.55%，33.33%，39.39% and 53.57% respectively，the total accuracy was 54.53%， less consistent with postoperative clinical pathologic results (Kappa=0.244, P=0.000).The accuracy of ultrasonography combined with chest x-ray for thyroid carcinoma M0 and M1 staging was 99.60% and 100.0% respectively，the total accuracy was 99.61%,better consistent with postoperative clinicopathologic results(Kappa=0.665,P=0.000).Conclusion Ultrasonography has high accuracy in T/N staging of thyroid carcinoma，Ultrasonography combined with chest x-ray has the highest accuracy of M staging of thyroid carcinoma, which was helpful to the selection of clinical treatment scheme and efficacy evaluation. |
| Key words: Ultrasonography Chest X-ray Thyroid carcinoma TNM staging |
