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单纯与合并良性病变的甲状腺癌彩超特征分析
伍春梅,赵子超,李金平
0
(宁夏医科大学;宁夏医科大学总医院肿瘤医院肿瘤外一科)
摘要:
目的 探讨单纯甲状腺癌与合并良性病变的甲状腺癌的彩超特征。方法 收集2016年11月~2017年11月宁夏医科大学总医院肿瘤医院收治的325例甲状腺癌患者的临床病理资料,对术前彩超特征进行分析。结果 单纯甲状腺癌的钙化类型与合并良性病变的甲状腺癌有明显差异(P<0.05)。单纯甲状腺癌实性结节显著多于甲状腺癌合并良性病变组(P<0.05)。单纯甲状腺癌包膜不光整结节显著多于甲状腺癌合并结节性甲状腺肿、甲状腺癌并结节性甲状腺肿并桥本氏甲状腺炎组(P<0.05)。甲状腺癌并桥本氏甲状腺炎组结节包膜不光整率显著高于甲状腺癌并结节性甲状腺肿组(P<0.05)。单纯甲状腺癌组结节以Ⅲ级血流信号为主,显著高于甲状腺癌并结节性甲状腺肿组(P<0.05)。甲状腺癌并桥本氏甲状腺炎组Ⅲ级血流信号所占比例显著高于甲状腺癌并结节性甲状腺肿组、甲状腺癌并结节性甲状腺肿并桥本氏甲状腺炎组(P<0.05)。单纯甲状腺癌组的钙化率显著高于甲状腺癌并结节性甲状腺肿组(P<0.05);甲状腺癌并桥本氏甲状腺炎组结节的粗大钙化率显著高于单纯甲状腺癌组(P<0.05)。彩超对甲状腺恶性肿瘤淋巴结转移情况的诊断灵敏性、特异性分别为26.27%、 92.53%。结论 单纯甲状腺癌在钙化、包膜、血流等彩超特征上与合并良性病变的甲状腺癌有差异,可能提示预后更差;合并良性病变的甲状腺癌结节的彩超特征不如单纯甲状腺癌典型,可能容易出现漏诊、误诊。
关键词:  甲状腺癌  结节性甲状腺肿  桥本氏甲状腺炎  彩超
DOI:
基金项目:国家自然科学基金(81760482);宁夏自然科学基金(NZ17138)
Ultrasound characteristics of purely thyroid cancer and thyroid cancer complicated with benign lesions
WU Chunmei,ZHAO Zichao,LI Jinping
(Ningxia Medical University;Department of Oncology, Cancer Hospital of Ningxia Medical University)
Abstract:
Objective To compare the features of purely thyroid cancer and thyroid cancer complicated with benign lesions. Methods 325 thyroid cancer patients diagnosed by pathology from November 2016 to November 2017 were enrolled in the study. The ultrasound characteristics were analyzed. Results Statistically significant differences were observed in the calcification type between purely thyroid cancer and thyroid cancer complicated with benign lesions (P<0.05). The rate of solid nodules in purely thyroid cancer were significantly higher than those in thyroid cancer complicated with benign lesions (P<0.05). Statistically significant differences were also observed in the rate of irregular capsule among purely thyroid cancer , thyroid cancer with nodular goiter, thyroid cancer complicated with both Hashimoto's thyroiditis and nodular goiter (P<0.05). The rate of irregular capsule in thyroid cancer complicated with Hashimoto's thyroiditis were higher than those in thyroid cancer with nodular goiter (P<0.05). The rate of Blood flow signal Ⅲin purely thyroid cancer were higher than those in thyroid cancer with nodular goiter (P<0.05). The thyroid cancer complicated with Hashimoto's thyroiditis had more Blood flow signal Ⅲ than thyroid cancer with nodular goiter, and thyroid cancer thatcomplicated with both Hashimoto's thyroiditis and nodular goiter (P<0.05). There were statistically significant differences in the rate of calcification between purely thyroid cancer and thyroid cancer with nodular goiter (P<0.05). The rate of macrocalcifications in thyroid cancer complicated with Hashimoto's thyroiditis were higher than those in purelythyroid cancer (P<0.05). The ultrasound diagnosis of metastatic lymph node in thyroid cancer sensitivity and specificity were 26.27% and 92.53%. Conclusion There are differences in Ultrasound characteristics such as calcification, capsule , blood flow signal between purely thyroid cancer and thyroid cancer complicated with benign lesions. Purely thyroid cancer may have poor prognosis than thyroid cancer complicated with benign lesions. The ultrasound characteristics of thyroid cancer complicated with benign lesions were not typical as purely thyroid cancer may causes misdiagnosis and missed diagnosis.
Key words:  Thyroid cancer  Nodular goiter  Hashimoto's thyroiditis  Ultrasound

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