中国实用外科杂志

中国实用外科杂志 ›› 2023, Vol. 43 ›› Issue (11): 1291-1294.DOI: 10.19538/j.cjps.issn1005-2208.2023.11.19

• 论著 • 上一篇    下一篇

应用细针穿刺洗脱液甲状腺球蛋白胶体金免疫层析检测法诊断甲状腺癌颈侧区淋巴结转移的可行性分析

王钰婷，渠    宁，马    奔，徐伟博，王    宇   

  1. 复旦大学附属肿瘤医院头颈外科 复旦大学上海医学院肿瘤学系，上海 200032
  • 出版日期:2023-11-01 发布日期:2023-11-04

  • Online:2023-11-01 Published:2023-11-04

摘要： 目的    探究细针穿刺洗脱液甲状腺球蛋白（FNA-Tg）胶体金免疫层析法（CGICA）检测甲状腺颈侧区淋巴结转移的诊断效能。方法    前瞻性收集2023年1月至2023年3月在复旦大学附属肿瘤医院头颈外科同一名医生收治的15例行颈淋巴结清扫的病人，收集病人术前穿刺组织洗脱液进行CGICA法测定。结合病人化学发光法检测所得的甲状腺球蛋白（Tg）水平，以及手术切除切除标本的冰冻及石蜡病理学切片，作为判断病人是否有颈侧区淋巴结转移的金标准。比较CGICA与金标准法测定结果。结果    共有28枚淋巴结送检，15枚淋巴结提示转移，其中CGICA法检测甲状腺乳头状癌与甲状腺未分化癌的结果与金标准一致，而检测甲状腺髓样癌及下咽鳞状细胞癌与金标准不符。结论    CGICA法检测甲状腺上皮来源肿瘤颈淋巴结转移有较好的诊断效能，但是检测非上皮来源甲状腺癌（髓样癌）、非甲状腺来源肿瘤颈淋巴结转移效果较差。CGICA法快捷、简便，安全可行，值得进一步验证以期可广泛应用于甲状腺乳头状癌及甲状腺滤泡状癌颈侧区淋巴结转移的临床检测。

关键词: 甲状腺癌, 颈淋巴结转移, 洗脱液, 甲状腺球蛋白, 胶体金免疫层析检测法 

Abstract: Feasility of using fine needle aspiration washout fluid thyroglobulin  colloidal gold immunochromatographic assay for diagnosis of lymph node metastasis in the lateral cervical region of the thyroid cancer        WANG Yu-ting,QU Ning,MA Ben,et al.Department of Head and Neck Surgery，Fudan University Shanghai Cancer Center; Department of Oncology，Shanghai Medical College，Fudan University,Shanghai 200032,China
Corresponding author:WANG Yu,E-mail：neck130@sina.com
Abstract    Objective    To validate the diagnostic performance of fine needle aspiration washout fluid thyroglobulin （FNA-Tg） colloidal gold immunochromatographic assay(CGICA) in detecting lymph node metastasis in the lateral cervical region of the thyroid cancer. Methods    A total of  15 patients who underwent neck lymph node dissection by the same doctor in Department of Head and Neck Surgery  Fudan University Cancer Center from January 2023 to March 2023 were prospectively collected.  Fine needle aspiration washout fluid of all patients were collected before operation and detectded by CGICA. Gold standard was used as combining  both the preoperative patient's thyroglobulin (Tg) level detected by the Roche chemiluminescence method and  the frozen and paraffin pathology of the surgical resection specimen to determine whether the patient has lymph node metastasis in the lateral cervical region.The results from CGICA and gold standard were copared. Results    A total of 28 lymph nodes were submitted for detection, and 15 lymph nodes showed metastasis. The results of the CGICA in detecting papillary thyroid cancer and anaplastic thyroid cancer were consistent with the gold standard, but the results in detecting medullary thyroid cancer and hypopharyngeal squamous cell carcinoma were not consistent with the gold standard. Conclusion    CGICA has good diagnostic performance in detecting cervical lymph node metastasis of thyroid epithelial tumors, but is less effective in detecting cervical lymph node metastasis of non-epithelial thyroid cancer (MTC) and non-thyroid tumors.  CGICA is fast and simple, safe and feasible,which worth further study in order to    apply widely in the clinical detection of cervical lymph node metastasis of papillary thyroid cancer and follicular thyroid cancer after relevant experimental verification.

Key words: thyroid cancer, cervical lymph node metastasis, washout fluid, thyroglobulin, colloidal gold immunochromatographic assay