[1]赵春颖.分化型甲状腺癌术后出现颈部可疑性淋巴结转移的超声随访及探讨[J].中国实用乡村医生杂志,2019,26(12):42-44.[doi:10.3969/j.issn.1672-7185.2019.12.014 ]
 ZHAO Chunying.Ultrasound Follow-up of Suspicious Neck Lymph Node Metastasis after Operation in Differentiated Thyroid Cancer[J].Chinese Practical Journal of Rural Doctor,2019,26(12):42-44.[doi:10.3969/j.issn.1672-7185.2019.12.014 ]
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分化型甲状腺癌术后出现颈部可疑性淋巴结转移的超声随访及探讨()
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《中国实用乡村医生杂志》[ISSN:1672-7185/CN:21-1502/R]

卷:
26
期数:
2019年12期
页码:
42-44
栏目:
临床研究
出版日期:
2019-12-15

文章信息/Info

Title:
Ultrasound Follow-up of Suspicious Neck Lymph Node Metastasis after Operation in Differentiated Thyroid Cancer
文章编号:
 1672-7185(2019)12-0042-03 
作者:
赵春颖
作者单位:122100 辽宁 北票,北票市中心医院超声科
Author(s):
ZHAO Chunying
(Department of Ultrasound, Beipiao Central Hospital, Beipiao 122100, Liaoning Province, China)
关键词:
 甲状腺癌分化型淋巴结转移可疑性超声随访
Keywords:
Thyroid Cancer Differentiated Type Lymph Node Metastasis Suspicion Ultrasound Follow-up
分类号:
 R736.1 
DOI:
10.3969/j.issn.1672-7185.2019.12.014
文献标志码:
 A
摘要:
 目的 动态观察分化型甲状腺癌( D T C)术后可疑性淋巴结转移的超声声像变化。方法 回顾性收集北票市中心医院2010—2015年收治的D T C术后出现可疑性淋巴结转移患者53例,记录首次检出可疑性淋巴结转移的声像特征;并继续以超声动态随访,观察可疑性淋巴结转移的声像变化。结果 315例D TC患者,术后出现可疑性淋巴结转移占16.83%。首次检出时淋巴结大小:长径5~11 mm,平均(7.2±1.7)mm;短径3~7 mm,平均(4.2±1.1)mm。内部声像:点状增强占50.94%;局灶高回声占11.32%;囊性变7.55%。淋巴门声像:消失占83.02%。随访过程中,失访4例、退出8例、随访41例。41例患者淋巴结大小:基本不变占78.05%;增大占14.63%;变小占7.32%。内部声像变化:点状增强消失占25.93%;局灶高回声消失占33.33%;囊性变消失占25.00%。淋巴门声像变化:结构恢复占20.45%;维持消失占79.55%。8例退出随访者与首次检出可疑性淋巴结转移时相比,仅1例患者淋巴结增大,长径>10 mm;其余淋巴结内部和淋巴门声像未出现明显变化。结论 大部分DTC患者术后颈部可疑性淋巴结转移在超声随访中未出现明显变化;对于可疑性淋巴结长径<10 mm者,可继续超声随访;而对于长径>10 mm者要警惕恶变。
Abstract:
Objective To dynamically observe the ultrasonographic changes of suspicious lymph node metastasis after operation for differentiated thyroid cancer (DTC). Methods A total of 53 patients with suspected lymph node metastasis after DTC in our hospital from 2010 to 2015 were retrospectively collected, and the sonographic features of suspected lymph node metastasis were recorded for the first time. The dynamic follow-up of ultrasound was continued to observe the sonographic changes of suspected lymph node metastasis. Results The 315 patients with DTC, 16.83% had suspected lymph node metastasis after operation. The size of lymph nodes at the first detection was 5~11 mm in length, with an average of (7.2±1.7) mm, and 3~7 mm in short diameter, with an average of (4.2±1.1) mm. Internal sonography: punctate enhancement accounted for 50.94%; focal hyperechoicity accounted for 11.32%; cystic degeneration 7.55%. Lymphatic portal ultrasonography: disappearance accounted for 83.02%. During the follow-up, 4 cases were lost, 8 cases were withdrawn and 41 cases were followed up. The size of lymph nodes in 41 patients was basically unchanged (78.05%), increased (14.63%) and decreased (7.32%). Internal sonographic changes: punctate enhancement disappeared in 25.93%; focal hyperechoic disappeared in 33.33%; cystic degeneration disappeared in 25.00%. Ultrasonographic changes of lymphatic hilum: structural recovery accounted for 20.45% and maintenance disappearance accounted for 79.55%. Compared with the first detection of suspected lymph node metastasis, only one patient had enlarged lymph nodes with a diameter of more than 10 mm, and the other lymph nodes had significant changes in internal and lymphatic hilar ultrasonography. Conclusion Most patients with suspected neck lymph node metastasis after DTC have no significant changes in ultrasound follow-up. For those with suspected lymph node diameter less than 10 mm, ultrasound follow-up can be continued, while those with longer diameter more than 10 mm should be vigilant against malignant transformation.

参考文献/References:

[1]郑向前,杨伟伟,王会娟,等.分化型甲状腺癌诊疗进展[J].中华普通外科杂志,2019,34(3):273-276.
[2] 中国医师协会外科医师分会甲状腺外科医师委员会,中国研究型医院学会甲状腺疾病专业委员会.分化型甲状腺癌颈侧区淋巴结清扫专家共识(2017版)[J].中国实用外科杂志,2017,37(9):985-991.
[3] 李平,武乃旺.分化型甲状腺癌的颈部淋巴结转移规律探讨[J].山西医科大学学报,2009,40(2):164-166.
[4] 孔繁云,符尚宏,何勇.超声联合细针穿刺洗脱液甲状腺球蛋白诊断乳头状甲状腺癌术后淋巴结转移的效能[J].癌症进展,2019,17(9):1047-1049,1082.
[5]胡敏霞,夏春霞,于风霞,等.分化型甲状腺癌术后颈部淋巴结可疑转移的超声随访研究[J].中国耳鼻咽喉头颈外科,2019,26(3):125-130.
[6] 任素华.甲状腺结节超声特征对甲状腺癌的诊断准确性分析[J].临床医药文献电子杂志,2018,5(99):141­142.
[7] 孟林.超声导引下细针穿刺洗脱液甲状腺球蛋白测定在分化型甲状腺癌颈部淋巴结转移中的价值[J].医药前沿,2017,7(16):150-151.
[8] HAUGEN BR, ALEXANDER EK, BIBLE KC, et al. 2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American thyroid association guidelines task force on thyroid nodules and diffcrentiated thyroid cancer[J]. Thyroid, 2016, 26(1): 1-133.

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备注/Memo

备注/Memo:
收稿日期:2019-08-02)

更新日期/Last Update: 2019-12-31