| 摘要: |
| 目的：探讨超声造影(CEUS)联合Lemur-酪氨酸激酶3(LMTK3)对于甲状腺乳头状癌(PTC)及其颈部淋巴结转移的诊断价值。方法：选取2019年2月-2022年2月本院收治的92例均行手术病理证实的甲状腺肿瘤患者,所有患者术前均行甲状腺CEUS检查和LMTK3检测。根据病理结果分为良性组(42例)和PTC组(50例),其中PTC组均行颈部淋巴结清扫,根据有无颈部淋巴结转移分为转移组(28例)和非转移组(22例)。分别比较良性组与PTC组、转移组与非转移组之间的CEUS、LMTK3水平差异。绘制受试者工作特征(ROC)曲线评估各参数对PTC及其颈部淋巴结转移的诊断价值。结果：PTC组CEUS等增强、低增强、非均匀增强、灌注缺损、增强时边界不清晰所占比例以及达峰时间(TTP)、LMTK3水平显著高于良性组,而峰值强度(PI)显著低于良性组,且差异具有统计学意义(P<0.05)。PTC颈部淋巴结转移组甲状腺结节的CEUS等增强、高增强、非均匀增强、灌注缺损、增强时边界不清晰所占比例以及TTP、PI、LMTK3水平显著高于非转移组,且差异具有统计学意义(P<0.05)。与CEUS和LMTK3水平单独诊断相比,两者联合诊断PTC及其颈部淋巴结转移的准确度、敏感度、特异度最高。结论：CEUS与LMTK3均对PTC及其颈部淋巴结转移具有一定的鉴别诊断价值,两者联合检测有助于提高术前对PTC及其颈部淋巴结转移的诊断准确率。 |
| 关键词: 甲状腺乳头状癌 淋巴结转移 超声造影 Lemur-酪氨酸激酶3 诊断价值 |
| DOI： |
| 投稿时间：2022-09-13修订日期：2022-10-24 |
| 基金项目:海南省卫生健康行业科研项目(项目编号: 21A200047) |
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| Diagnostic value of contrast-enhanced ultrasound combined with Lemur-tyrosine kinase 3 in papillary thyroid carcinoma and cervical lymph node metastasis |
| Yang Kefeng,Chen Kai-liang,Lai Ji-neng,Lin Qi |
| (Department of Ultrasonography) |
| Abstract: |
| Objective: To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS) combined with lemur tyrosine kinase 3 (LMTK3) in papillary thyroid carcinoma (PTC) and cervical lymph node metastasis. Methods: 92 patients with thyroid tumors confirmed by operation and pathology in our hospital From February 2019 to February 2022 were selected. All patients underwent thyroid CEUS examination and LMTK3 examination before operation. The patients were divided into benign group (42 cases) and PTC group (50 cases) according to the pathological results, The PTC group underwent neck lymph node dissection, the patients were divided into metastasis group (28 cases) and non metastasis group (22 cases) According to the presence or absence of neck lymph node metastasis. The levels of CEUS and LMTK3 were compared between benign group and PTC group, metastatic group and non metastatic group. The receiver operating characteristic (ROC) curve were drawn to evaluate the diagnostic value of various parameters for PTC and cervical lymph node metastasis. Results: The proportion of CEUS enhancement, low enhancement, non-uniform enhancement, perfusion defect, unclear boundary during enhancement, time to peak (TTP) and LMTK3 level were significantly higher In PTC group than in benign group, while the peak intensity (PI) were significantly lower than that in benign group, and the difference was statistically significant (P<0.05). The proportion of CEUS enhancement, high enhancement, non-uniform enhancement, perfusion defect, unclear boundary during enhancement, TTP, PI and LMTK3 levels in thyroid nodules were significantly higher in PTC cervical lymph node metastasis group than in non metastasis group, and the difference was statistically significant (P<0.05). Compared with CEUS and LMTK3 alone, the combined diagnosis of PTC and cervical lymph node metastasis has the highest accuracy, sensitivity and specificity. Conclusion: CEUS and lmtk3 have certain differential diagnostic value for PTC and cervical lymph node metastasis. The combined detection of CEUS and LMTK3 can help to improve the diagnostic accuracy of PTC and cervical lymph node metastasis before operation. |
| Key words: papillary thyroid carcinoma lymph node metastasis contrast-enhanced ultrasound Lemur-tyrosine kinase 3 diagnostic value |
