术中穿刺检测鉴别淋巴结与甲状旁腺28例临床研究

发布时间：2019-03-29 11:49

【摘要】：目的探讨术中穿刺快速检测鉴别淋巴结和甲状旁腺的可行性。方法选择2014年1-7月第四军医大学西京医院收治的28例甲状腺癌病人,均行甲状腺癌根治术。行术中冰冻病理学检查的同时进行术中穿刺快速检测,比较两种方法的敏感度、特异度等诊断效能指标。结果 28例病人术中共检出40枚可疑结节,包含29枚可疑甲状旁腺、9枚可疑淋巴结、2枚可疑结节。甲状旁腺的术中总检出率为27.5%(11/40),淋巴结的总检出率为37.5%(15/40)。冰冻病理学检查与术后病理学检查一致,故以其为金标准,术中穿刺快速检测鉴定淋巴结的准确率为100%,鉴定甲状旁腺的准确率为93.1%(1例假阳性),敏感度为100%,特异度为97.0%。结论术中穿刺快速检测可准确鉴别术中可疑淋巴结,有助于甲状旁腺的保护及原位保留。
[Abstract]:Objective to explore the feasibility of rapid detection of lymph nodes and parathyroid glands by intraoperative puncture. Methods from January to July, 2014, 28 patients with thyroid cancer were treated with radical thyroidectomy in Xijing Hospital, fourth military Medical University. The sensitivity and specificity of the two methods were compared. Results A total of 40 suspicious nodules were detected in 28 patients, including 29 suspected parathyroid glands, 9 suspicious lymph nodes and 2 suspicious nodules. The total detection rate of parathyroid gland and lymph node were 27.5% (11 / 40) and 37.5% (15 / 40) respectively. The frozen pathological examination was consistent with the postoperative pathological examination, so the accuracy of rapid detection of lymph nodes and parathyroid gland was 100%, 93.1% (1 false positive) and 100%, respectively, according to the gold standard. The specificity was 97.0%. Conclusion the rapid detection of intraoperative puncture can accurately identify suspected lymph nodes, which is helpful to the protection and in situ preservation of parathyroid gland.
【作者单位】：第四军医大学西京医院甲乳血管外科;第四军医大学西京医院病理科;
【基金】：国家自然科学基金(No.8157110197)
【分类号】：R653

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