超声引导下颈淋巴结穿刺联合血清TSH、SIL-2R水平检测与甲状腺癌患者颈部淋巴结转移及疾病严重程度的关系

doi:10.3969/j.issn.1007-3205.2020.04.015

河北医科大学学报

超声引导下颈淋巴结穿刺联合血清TSH、SIL-2R水平检测与甲状腺癌患者颈部淋巴结转移及疾病严重程度的关系

1.武警四川省总队医院耳鼻咽喉头颈外科，四川乐山 614000；2.武警四川省总队医院特诊科,四川乐山 614000

出版日期:2020-04-25 发布日期:2020-05-15
作者简介:王刚（1982-），男，四川岳池人，武警四川省总队医院主治医师，医学学士，从事耳鼻咽喉头颈外科疾病诊治研究。

Relationship between ultrasound-guided cervical lymph node puncture combined with serum TSH and SIL-2R levels in cervical lymph node metastasis and disease severity in patients with thyroid cancer#br#

1.Department of Otolaryngology and Head and Neck Surgery， Armed Police Sichuan Provincial
General Hospital， Sichuan Province， Leshan 614000， China； 2.Department of Special Clinic，
Armed Police Sichuan Provincial General Hospital， Sichuan Province， Leshan 614000， China

Online:2020-04-25 Published:2020-05-15

摘要/Abstract

摘要： ［摘要］
目的探讨超声引导下颈淋巴结穿刺联合血清促甲状腺激素（thyrotropin， TSH）、可溶性白细胞介素2受体（soluble interleukin-2 receptor，SIL-2R）水平检测与甲状腺癌患者颈部淋巴结转移及疾病严重程度的关系。
方法选择甲状腺癌患者120例，根据手术后病理结果分为Ⅰ/Ⅱ期组和Ⅲ/Ⅳ期组以及无转移组和转移组。所有患者均行超声引导下颈淋巴结穿刺检查，并检测血清TSH、SIL-2R水平。
结果超声引导下颈淋巴结穿刺检测出106例淋巴结转移，准确率为85.00%（102/120）。超声引导下颈淋巴结穿刺对于Ⅱ期、Ⅲ期、Ⅳ期的淋巴结转移检测的准确率明显高于对于Ⅰ期甲状腺癌淋巴结转移的准确率（P＜0.01）。Ⅲ/Ⅳ期组血清TSH和SIL-2R水平明显高于Ⅰ/Ⅱ期组（P＜0.01）。甲状腺癌患者血清TSH和SIL-2R水平与病理分期呈正相关（P＜0.01）。转移组血清TSH和SIL-2R水平明显高于无转移组（P＜0.01）。对于甲状腺癌颈部淋巴结转移，超声穿刺、TSH、SIL-2R平行联合检测的准确度、敏感度、阴性预测值明显高于单项联合检测。
结论 Ⅲ/Ⅳ期或合并颈部淋巴结转移的甲状腺癌患者具有更高的血清TSH、SIL-2R水平，并且超声引导下颈淋巴结穿刺与血清TSH、SIL-2R联合检测可提高诊断的准确度和敏感度。

关键词: 甲状腺肿瘤, 穿刺术, 促甲状腺素, 可溶性白细胞介素2受体

Abstract: ［Abstract］Objective〖HTSS〗To explore the relationship between ultrasound-guided cervical lymph node puncture combined with thyrotropin(TSH) and oluble interleukin-2 receptor(SIL-2R) and cervical lymph node metastasis and disease severity in patients with thyroid cancer.
〖WTHZ〗Methods〖HTSS〗One hundred and twenty patients with thyroid cancer were selected and divided into stage Ⅰ/Ⅱ group and stage Ⅲ/Ⅳ group, non-metastatic group and metastatic group according to the postoperative pathological results. All patients underwent ultrasound-guided cervical lymph node aspiration and their serum TSH and SIL-2R levels were measured.
〖WTHZ〗Results〖HTSS〗Ultrasound-guided cervical lymph node aspiration detected 106 lymph node metastases with an accuracy rate of 85.00%(102/120). The accuracy of ultrasound-guided cervical lymph node aspiration for stage Ⅱ, Ⅲ, and Ⅳ lymph node metastasis was significantly higher than that for stage thyroid cancer lymph node metastasis(P＜0.01). The levels of serum TSH and SIL-2R in stage Ⅲ/Ⅳ group were significantly higher than those in stage Ⅰ/Ⅱ group(P＜0.01). Serum TSH and SIL-2R levels were positively correlated with pathological stage in patients with thyroid cancer(P＜0.01). Serum TSH and SIL-2R levels in the metastatic group were significantly higher than those in the non-metastatic group(P＜0.01). For cervical lymph node metastasis of thyroid cancer, the accuracy, sensitivity, and negative predictive value of the combined ultrasound puncture, TSH, and SIL-2R parallel tests were significantly higher than those of the single test.
〖WTHZ〗Conclusion〖HTSS〗Patients with stage Ⅲ/Ⅳ or thyroid cancer with cervical lymph node metastasis have higher serum TSH and SIL-2R levels. Ultrasound-guided cervical lymph node aspiration combined with serum TSH and SIL-2R detection can improve the accuracy and sensitivity of diagnosis.

Key words: thyroid neoplasms； punctures； thyrotropin, soluble interleukin-2 receptor

王刚1，谢丽娟2，张明菊1. 超声引导下颈淋巴结穿刺联合血清TSH、SIL-2R水平检测与甲状腺癌患者颈部淋巴结转移及疾病严重程度的关系[J]. 河北医科大学学报, doi: 10.3969/j.issn.1007-3205.2020.04.015.

WANG Gang1, XIE Li-juan2， ZHANG Ming-ju1. Relationship between ultrasound-guided cervical lymph node puncture combined with serum TSH and SIL-2R levels in cervical lymph node metastasis and disease severity in patients with thyroid cancer#br#[J]. Journal of Hebei Medical University, doi: 10.3969/j.issn.1007-3205.2020.04.015.

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超声引导下颈淋巴结穿刺联合血清TSH、SIL-2R水平检测与甲状腺癌患者颈部淋巴结转移及疾病严重程度的关系

Relationship between ultrasound-guided cervical lymph node puncture combined with serum TSH and SIL-2R levels in cervical lymph node metastasis and disease severity in patients with thyroid cancer#br#

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