Tg变化对甲状腺癌转移性淋巴结检测特异性分析-现代医学

Tg变化对甲状腺癌转移性淋巴结检测特异性分析

单位：西安交通大学第二附属医院普外科, 陕西西安 710004

分类号：R581.3

出版年·卷·期（页码）：2017·36·第八期（1076-1079）

摘要：

目的：探讨甲状腺球蛋白（Tg）检测对于甲状腺癌转移性淋巴结的诊断价值。方法：选取2013年1月~2015年12月本院实施甲状腺癌伴颈部淋巴结肿大患者382例，采用超声引导下淋巴结细针穿刺术处理，对穿刺物洗脱液采用电化学发光法检测Tg （FNA-Tg）进行检测，探讨FNA-Tg不同阳性标准值下诊断转移性淋巴结的价值。结果：病检结果淋巴结转移阳性患者的FNA-Tg水平显著的高于淋巴结转移阴性的患者，差异具有统计学意义（P<0.05）；以手术病理结果作为标准（表2），FNA-Tg检测值与血清Tg比值 > 1时判断为淋巴结转移阳性的灵敏度为91.51%、特异度为87.39%；FNA-Tg > 10 ng/ml判断为淋巴结转移阳性的灵敏度为95.94%、特异度为68.47%；两种判断标准联合应用时：判断为淋巴结转移阳性的灵敏度为98.89%、特异度为94.59%。结论：FNA-Tg检测值与血清Tg比值 > 1联合FNA-Tg检测值 > 10 ng/ml值作为判断甲状腺癌淋巴结转移的标准具有更高的实用价值。

Objective: To investigate the value of thyroid globulin(Tg) detection in the diagnosis of metastatic lymph nodes in thyroid carcinoma. Methods: From January 2013 to December 2015 in our hospital, 382 patients with thyroid carcinoma with cervical lymph node enlargement implemented ultrasound guided fine needle biopsy of lymph nodes, the puncture eluent underwent electrochemical detection of Tg chemiluminescence(FNA-Tg) detection. FNA-Tg positive standard value under different diagnostic value of metastatic lymph nodes was explored. Results: In positive pathological results of lymph node metastasis patients, FNA-Tg level was significantly higher than that in negative lymph node metastasis patients, the difference was statistically significant(P<0.05). When setting the pathology results as the standard(Table 2), and FNA-Tg value of serum/Tg ratio > 1 for the judging lymph node metastasis positive, the sensitivity was 91.51%, specificity 87.39%; when setting FNA-Tg > 10 ng/ml for judging lymph node metastasis positive, the sensitivity was 95.94%, specificity was 68.47%; when the two criteria were combined for detecting lymph node metastasis, the, sensitivity was 98.89%, specificity was 94.59%. Conclusion: FNA-Tg/serum Tg ratio > 1 combined with FNA-Tg value > 10 ng/ml as a standard for judging lymph node metastasis of thyroid cancer, has a practical value.

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