论文部分内容阅读
目的 分析讨论在诊断甲状腺癌颈淋巴结转移中彩超及D2-40免疫组化检测的临床应用价值.方法 将45例经手术病理确诊的甲状腺癌患者定为观察组,40例甲状腺腺瘤定为对比组A,并将31例甲状腺腺瘤者腺癌旁经病理证实为正常甲状腺组织者定为对比组B,所有患者均进行术前彩超检查和免疫组化检测D2-40表达,检测结果采用D2-40标记的微淋巴管密度(LVD)进行表述,分析比较各组检测情况.结果 观察组经彩超诊断为甲状腺癌组颈淋巴结转移的患者中有39例与术后病理诊断结果相符,彩超诊断符合率为86.7％.经门诊颈部触诊检查符合率为66.7％,两者相较彩超诊断与术后病理诊断结果的符合率明显更高(P＜0.05).观察组的LVD明显高于对比组A和对比组B(P＜0.05),且对比组A的LVD明显高于对比组B(P＜0.05).结论 彩超诊断可有效判断甲状腺癌颈淋巴结转移,其与术后病理诊断具有较高的符合率,如影像学检查无法明确判断是否具有颈淋巴结转移则可采用D2-40免疫组化检测,其可提高诊断率并为颈清扫提供可靠依据,具有重要意义.“,”Objective To investigate the clinical application value of node metastasis ultrasonography and D2-40 immunohistochemical detection on cervical lymph diagnosis of thyroid carcinoma.Methods Forty-five patients with thyroid cancer confirmed by operation and pathology were chosen as the observation group.Forty cases of thyroid adenoma as contrast group A,and 31 cases of thyroid adenoma or adenocarcinoma was pathologically confirmed with normal thyroid organizers as contrast group B.All patients underwent preoperative ultrasonography and D2-40 expression was detected by immunohistochemistry.The detection results were expressed by D2-40 markers of the lymphatic microvessel density (LVD).Analysed and compared the each detection.Results In the observation group,39 cases were diagnosed with thyroid cancer cervical lymph node metastasis,which was conformed to the postoperative pathological diagnosis results.Color Doppler ultrasound diagnosis coincidence rate was 86.7％.The outpatient cervical palpation examination qualified rate was 66.7％.The coincident rate of colorful color Doppler ultrasound diagnosis and pathologic diagnosis after operation was significantly higher (P ＜ 0.05).LVD in the observation group was significantly higher than that of contrast group A and contrast group B (P ＜ 0.05).Compared with contrast group B,LVD was significantly higher in the contrast group A (P ＜ 0.05).Conclusions Ultrasound diagnosis can effectively judge the neck lymph node of thyroid carcinoma metastasis,and has high coincidence rate with the postoperative pathological diagnosis.If the imaging is unable to judge whether it has cervical lymph node metastasis,D2-40 immunohistochemistry can be used.It can improve the diagnosis rate and reliable basis of neck dissection,so it has vital significance.