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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 diagnostic value of thyroglobulin (Tg) detection in metastatic lymph nodes of thyroid cancer. Methods: From January 2013 to December 2015, 382 patients with thyroid carcinoma and cervical lymph node enlargement underwent ultrasound-guided lymph node fine needle aspiration in our hospital. The electrophorometry Tg (FNA-Tg) were measured to explore the diagnostic value of FNA-Tg with different positive standard values in metastatic lymph nodes. Results: The positive rate of FNA-Tg in patients with positive lymph node metastasis was significantly higher than that in patients with negative lymph node metastasis (P <0.05). The pathological results were used as the standard (Table 2), FNA-Tg The sensitivity of 91.51% and specificity of 87.39% for the positive lymph node metastasis was 95.94% and 68.47% for the positive lymph node metastasis with FNA-Tg> 10 ng / ml. When the two criteria were used in combination, the sensitivity of positive lymph node metastasis was 98.89% and the specificity was 94.59%. Conclusion: The ratio of FNA-Tg to serum Tg> 1 in combination with FNA-Tg> 10 ng / ml is of great practical value in judging lymph node metastasis of thyroid cancer.