Diagnostic value of shear wave elastography and FNA-Tg in cervical lymph node metastasis of thyroid papillary carcinoma

Han Yunxia; Liu Liyun; Ouyang Xiangliu; Wang Yanbin

doi:10.13406/j.cnki.cyxb.003206

您当前的位置：

首页 >

文章列表页 >

Diagnostic value of shear wave elastography and FNA-Tg in cervical lymph node metastasis of thyroid papillary carcinoma

Clinical research | 更新时间：2025-10-21

- Diagnostic value of shear wave elastography and FNA-Tg in cervical lymph node metastasis of thyroid papillary carcinoma
- Journal of Chongqing Medical University Vol. 48, Issue 4, Pages: 462-466(2023)
- 作者机构：
  
  1.唐山市工人医院，超声医学科，唐山 063000
  2.唐山市工人医院，病理科，唐山 063000
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003206
  CLC： R445.1;R736.1
- Received：24 July 2022，
  
  Revised：2022-12-21，
  
  Accepted：04 January 2023，
  
  Published：28 April 2023
- 稿件说明：
移动端阅览
韩云霞,刘丽云,欧阳向柳,等.剪切波弹性成像与FNA-Tg对甲状腺乳头状癌侧颈部淋巴结转移的诊断价值[J].重庆医科大学学报,2023,48(4):462-466.

Han Yunxia,Liu Liyun,Ouyang Xiangliu,et al.Diagnostic value of shear wave elastography and FNA-Tg in cervical lymph node metastasis of thyroid papillary carcinoma[J].Journal of Chongqing Medical University,2023,48(4):462-466.
韩云霞,刘丽云,欧阳向柳,等.剪切波弹性成像与FNA-Tg对甲状腺乳头状癌侧颈部淋巴结转移的诊断价值[J].重庆医科大学学报,2023,48(4):462-466. DOI： 10.13406/j.cnki.cyxb.003206.

Han Yunxia,Liu Liyun,Ouyang Xiangliu,et al.Diagnostic value of shear wave elastography and FNA-Tg in cervical lymph node metastasis of thyroid papillary carcinoma[J].Journal of Chongqing Medical University,2023,48(4):462-466. DOI： 10.13406/j.cnki.cyxb.003206.

摘要

目的

探讨剪切波弹性成像（shear wave elastography，SWE）与细针穿刺洗脱液甲状腺球蛋白（fine-needle aspiration washout thyroglobulin，FNA-Tg）对甲状腺乳头状癌侧颈部淋巴结转移的诊断价值。

方法

回顾性分析159例经病理证实为甲状腺乳头状癌（papillary thyroid carcinoma，PTC）的患者资料，对颈部211枚可疑淋巴结进行常规超声、SWE参数平均值（E

mean

）、FNA-Tg检查，以术后病理结果为金标准，比较各检测方法的诊断效能。

结果

①SWE E

mean

转移组[（50.96±27.66） kPa

]

高于非转移组[（32.20±17.34） kPa

]

，差异有统计学意义（

=8.761，

0.01）。受试者工作特征（receiver operating characteristic，ROC）曲线分析表明，SWE E

mean

最佳诊断阈值为40.42 kPa时对PTC颈部淋巴结转移预测价值较高，曲线下面积（area under the curve，AUC）为0.849（95％CI=0.795~0.902，

0.01）。②与SWE E

mean

比较，联合法敏感度、特异度、准确度、阳性预测值及阴性预测值均显著提高（

=7.724、28.230、35.094、21.731、9.890，

0.005、

0.000、

0.000、0.002）。与FNA-Tg比较，联合法敏感度、特异度、准确度、阳性预测值及阴性预测值也显著提高（

=7.724、6.014、13.526、6.137、7.602，

0.005、0.014、

0.000、0.013、0.006）。③在淋巴结有囊性变和无囊性变时，SWE E

mean

的准确度分别为53.8%和79.8%，差异有统计学意义（

=4.819，

=0.028）；FNA-Tg的准确度分别为92.3%和87.4%，差异无统计学意义（

=0.275，

=0.600）。

结论

FNA-Tg诊断PTC转移淋巴结的准确度较高，且不受淋巴结有无囊性变的影响，与SWE E

mean

联合后可显著提高诊断效能。

Abstract

Objective

To investigate shear wave elastography（SWE）and fine-needle aspiration washout thyroglobulin（FNA-Tg）in the diagnosis of cervical lymph node metastasis of thyroid papillary carcinoma.

Methods

The data of 159 patients with papillary thyroid carcinoma（PTC） confirmed by pathology were analyzed retrospectively，and 211 suspected lymph nodes in the neck were examined by ultrasonic examination，SWE E

mean

and FNA-Tg. The diagnostic efficacy of each method was compared with the postoperative pathological results as the gold standard.

Results

①The SWE E

mean

metastasis group [（50.96±27.66） kPa

]

was significantly higher than the non-metastasis group [（32.20±17.34） kPa

]

，with a statistically significant difference（

=8.761，

0.01）. The receiver operating characteristic（ROC） curve analysis showed that SWE E

mean

optimal diagnostic threshold of 40.42 kPa had a higher predictive value for cervical lymph node metastasis of PTC，with an area under the curve（AUC） of 0.849（95%CI=0.795-0.902，

0.01）. ②Compared with SWE E

mean

，the sensitivity，specificity，diagnostic value，positive predictive value and negative predictive value were significantly increased（

=7.724，28.230，35.094，21.731，9.890；

0.005，

0.000，

0.000，0.002）. Compared with FNA-Tg，the sensitivity，specificity，diagnostic value，positive predictive value and negative predictive value of the combined method were significantly increased（

=7.724，6.014，13.526，6.137，7.602；

0.005，0.014，

0.000，0.013，0.006）. ③The accuracy of SWE E

mean

was 53.8% with and 79.8% without cystic changes in lymph nodes，respectively，with a statistical significance（

=4.819，

=0.028）. The accuracy of FNA-Tg was 92.3% and 87.4%，respectively，with no significant difference（

=0.275，

=0.600）.

Conclusion

FNA-Tg has a high accuracy in the diagnosis of PTC metastatic lymph nodes，and is not affected by the presence or absence of cystic changes in lymph nodes. The combination of SWE E

mean

and FNA-Tg can significantly improve the diagnostic efficiency.

关键词

Keywords

references

Bray F ， Ferlay J ， Soerjomataram I ， et al . Global cancer statistics 2018：GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries [J ] . CA A Cancer J Clin ， 2018 ， 68 （ 6 ）： 394 - 424 .

李秀芹 . 超声造影对甲状腺乳头状癌和颈部淋巴结转移的诊断价值 [J ] . 安徽医药， 2020 ， 24 （ 3 ）： 508 - 511，641 .

Li XQ . Diagnostic value of contrast-enhanced ultrasound in papillary thyroid carcinoma and cervical lymph node metastasis [J ] . Anhui Med Pharm J ， 2020 ， 24 （ 3 ）： 508 - 511，641 .

田　睿 . 剪切波弹性成像的弹性指数预测乳头状甲状腺癌颈部淋巴结转移的价值分析 [J ] . 当代医学， 2022 ， 28 （ 4 ）： 1 - 4 .

Tian R . Analysis of the value of shear wave elastography elastic index in predicting cervical lymph node metastasis of papillary thyroid cancer [J ] . Contemp Med ， 2022 ， 28 （ 4 ）： 1 - 4 .

Kim DW ， Jeon SJ ， Kim CG . Usefulness of thyroglobulin measurement in needle washouts of fine-needle aspiration biopsy for the diagnosis of cervical lymph node metastases from papillary thyroid cancer before thyroidectomy [J ] . Endocrine ， 2012 ， 42 （ 2 ）： 399 - 403 .

Moon JH ， Kim YI ， Lim JA ， et al . Thyroglobulin in washout fluid from lymph node fine-needle aspiration biopsy in papillary thyroid cancer：large-scale validation of the cutoff value to determine malignancy and evaluation of discrepant results [J ] . J Clin Endocrinol Metab ， 2013 ， 98 （ 3 ）： 1061 - 1068 .

Seethala RR ， Chiosea SI ， Liu CZ ， et al . Clinical and morphologic features of ETV6-NTRK3 translocated papillary thyroid carcinoma in an adult population without radiation exposure [J ] . Am J Surg Pathol ， 2017 ， 41 （ 4 ）： 446 - 457 .

Ke ZF ， Liu YH ， Zhang YJ ， et al . Diagnostic value and lymph node metastasis prediction of a custom‑made panel（thyroline）in thyroid cancer [J ] . Oncol Rep ， 2018 ， 40 （ 2 ）： 659 - 668 .

王晓庆，魏　玮，魏玺，等 . 甲状腺乳头状癌的超声表现及其与颈部中央区淋巴结转移的关系 [J ] . 中华肿瘤杂志， 2018 ， 40 （ 3 ）： 196 - 200 .

Wang XQ ， Wei W ， Wei X ， et al . Study on the relationship between ultrasonographic features of papillary thyroid carcinoma and central cervical lymph node metastasis [J ] . Chin J Oncol ， 2018 ， 40 （ 3 ）： 196 - 200 .

胡紫玥，卢　漫，王璐，等 . 三维剪切波弹性成像诊断甲状腺结节良恶性的初步应用 [J ] . 中华医学超声杂志（电子版）， 2020 ， 17 （ 1 ）： 11 - 16 .

Hu ZY ， Lu M ， Wang L ， et al . Preliminary application of three-dimensional shear wave elastography in diagnosis of thyroid nodules [J ] . Chin J Med Ultrasound Electron Ed ， 2020 ， 17 （ 1 ）： 11 - 16 .

齐淑轶，邓莅霏，谢　梅，等 . FNAC与FNA-Tg测定诊断分化型甲状腺癌颈淋巴结转移的比较研究 [J ] . 实用癌症杂志， 2019 ， 34 （ 3 ）： 457 - 459 .

Qi SY ， Deng LF ， Xie M ， et al . Comparative study on cytology and thyroglobulin measurement in fine-needle aspiration in the diagnosis of differentiated thyroid cancer cervical lymph node metastasis [J ] . Pract J Cancer ， 2019 ， 34 （ 3 ）： 457 - 459 .

纪丽丽，姜双全，李守强，等 . 穿刺洗脱液甲状腺球蛋白测定在诊断甲状腺乳头状癌转移淋巴结中的应用 [J ] . 中华超声影像学杂志， 2019 ， 28 （ 4 ）： 313 - 317 .

Ji LL ， Jiang SQ ， Li SQ ， et al . Application of thyroglobulin measurement in fine-needle aspiration for detecting lymph node metastasis in papillary thyroid carcinoma [J ] . Chin J Ultrason ， 2019 ， 28 （ 4 ）： 313 - 317 .

Khadra H ， Mohamed H ， Al-Qurayshi Z ， et al . Superior detection of metastatic cystic lymphadenopathy in patients with papillary thyroid cancer by utilization of thyroglobulin washout [J ] . Head Neck ， 2019 ， 41 （ 1 ）： 225 - 229 .

孙晶晶，李　丽，李佩佩，等 . 不同超声征象下FNAC与FNA-Tg对分化型甲状腺癌术前颈部淋巴结转移诊断价值 [J ] . 中国超声医学杂志， 2021 ， 37 （ 11 ）： 1208 - 1211 .

Sun JJ ， Li L ， Li PP ， et al . Analysis of the diagnostic value of FNAC and FNA-Tg in preoperative cervical lymph node metastasis of differentiated thyroid cancer under different sonographic features [J ] . Chin J Ultrasound Med ， 2021 ， 37 （ 11 ）： 1208 - 1211 .

王莎莎，石远凯，韩晓红 . FNA-Tg检测分化型甲状腺癌淋巴结转移的诊断效能及其影响因素 [J ] . 中华检验医学杂志， 2020 ， 43 （ 6 ）： 670 - 677 .

Wang SS ， Shi YK ， Han XH . The diagnostic efficacy of FNA-Tg in detecting lymph node metastasis of differentiated thyroid cancer and its influencing factors [J ] . Chin J Lab Med ， 2020 ， 43 （ 6 ）： 670 - 677 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Benefits of different surgical methods for 1-2 central lymph node metastases during operation of papillary thyroid carcinoma

Study on the repeatability of shear wave elastography in measuring cervical hardness

Correlation between the preoperative abundance of fine-needle aspiration (FNA)-BRAF^V600Emutations and clinicopathological features of papillary thyroid carcinoma

Clinical value of ultrasound, PET/CT and their combined detection in lymph node metastasis of malignant melanoma

Correlation analysis between lymph node metastasis and microRNA expression in gastric cancer

Related Author

Su Xinliang

Zhuang Yuchen

Huang Chun

Wang Hui

Shi Fengshuo

Cai Lu

Cui Liqing

Zhang Yan

Related Institution

Department of Breast and Thyroid Surgery，The First Affiliated Hospital of Chongqing Medical University

Department of Ultrasound，University-Town Hospital of Chongqing Medical University

Department of Thyroid and Breast Surgery

Department of Ultrasound

Department of Endocrinology， Affiliated Hospital of Integrated Traditional Chinese and Western Medicine of Nanjing University of Chinese Medicine

⁰