中国实用外科杂志

中国实用外科杂志 ›› 2011, Vol. 31 ›› Issue (05): 426-428.

• 论著 • 上一篇    下一篇

超声诊断176例假阴性甲状腺癌因素分析

王海玲，张    晟，忻晓洁，徐    勇，魏    玺   

  1. 天津医科大学附属肿瘤医院超声诊断治疗科  天津市肿瘤防治重点实验室，天津300060
  • 出版日期:2011-05-01 发布日期:2011-05-30

  • Online:2011-05-01 Published:2011-05-30

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摘要：

目的    探讨彩色超声诊断176例假阴性甲状腺癌的因素，研究假阴性结果的临床、影像学和组织学特征。方法    回顾性分析2007-2009年天津医科大学附属肿瘤医院收治的均经病理证实的1466例原发性甲状腺癌，比较176例术前超声诊断假阴性病例与1290例真阳性病例的之间的临床、影像学及病理组织学的差异。结果    （1）假阴性组与真阳性组发病年龄分别为（45.7±11.6）岁、（43.9±13.4）岁，两组之间差异无统计学意义。（2）假阴性组常合并结节性甲状腺肿或桥本甲状腺炎。（3）假阴性组中微小癌所占比例大于真阳性组。（4）假阴性组比真阳性组较少伴有颈部转移性淋巴结。（5）假阴性组滤泡癌所占比例比真阳性组多；假阴性组弥漫硬化型乳头状癌所占比例比真阳性组少。 结论    超声诊断假阴性的甲状腺癌病人常合并其他疾病、肿瘤较小、较少伴有颈部淋巴结转移，组织病理学类型及分型有一定的特点。临床有可疑之处时，应当进一步明确诊断，以免延误治疗。

关键词: 甲状腺癌, 彩色超声, 假阴性

Abstract:

Factors of color ultrasound diagnosis of false negative thyroid cancer: an analysis of 176 cases        WANG Hai-ling, ZHANG Sheng, XIN Xiao-jie, et al. Department of Ultrasound Diagnosis and Treatment, Tianjin Medical University Cancer Institute and Hospital, Tianjin300060, China
Corresponding author: WANG Hai-ling, E-mail:whailing2226666@yahoo.cn
Abstract    Objective    To study the factors of color Doppler ultrasound diagnosis of 176 cases of false negative thyroid cancer and to evaluate the clinical, radiological and histological features of false negative results. Methods    The data of 1466 cases of primary thyroid cancer confirmed by pathology between 2007 and 2009 at Tianjin Medical University Cancer Institute and Hospital were analyzed retrospectively. The clinical, imageology and histopathological differences between 176 preoperative false negative cases and 1290 true positive cases were compared. Results    (1) The age of false-negative group and true positive group were 45.7 ± 11.6 and 43.9 ± 13.4 years old respectively. There was no significant difference between two groups. (2) The false negative group was often associated with nodular goiter or Hashimoto's thyroiditis. (3) The proportion of microcarcinoma in false negative group was greater than that in true positive group. (4) The false negative group was less associated with cervical metastatic lymph nodes compared with the true positive group. (5) The proportion of follicular carcinoma in the false negative group was more than that in true positive group. The proportion of diffuse sclerosing variant of papillary carcinoma in the false negative group was less than that in the true positive group. Conclusion    False negative thyroid cancer cases diagnosed by ultrasound is often associated with other diseases. Smaller tumor size, less associated with cervical lymph node metastasis, histological type and subtypes have certain characteristics. When there is clinical suspicion, the diagnosis should be further clarified, so as not to delay treatment.

Key words:  , thyroid cancer；color ultrasound；false negative