标题：滤泡型甲状腺乳头状癌和经典型甲状腺乳头状癌超声表现与病理对照分析

      作者：代妮娜 1，皮小兰 2，张文君 1    （1.十堰市太和医院湖北医药学院附属医院超声科，湖北 十堰 442000；2.南昌大学第二附属医院超声科，江西 南昌 330006）

      卷次： 2016年27卷22期

      【摘要】 目的 探讨滤泡型甲状腺乳头状癌（FVPTC）和经典型甲状腺乳头状癌（C-PTC）的超声声像图特征及病理基础。方法 收集我院自2009年1月至2015年6月经手术病理证实的40例FVPTC和51例C-PTC的超声影像资料，回顾性分析两组结节的超声声像图特征，并结合病理结果进行对照研究。结果 C-PTC组患者术前超声诊断符合率为85.2%，明显高于FVPTC组的56.1%，差异有统计学意义(P<0.05)；FVPTC组与C-PTC组相比，形态规则(47.5%)、边界清晰(60.0%)、等回声(52.5%)、无钙化(52.5%)、有声晕(60.0%)、周边为主型血流(42.5%)及无淋巴结累计(70.0%)在FVPTC组中更常见。形态不规则(51.0%)、边界不清晰(64.7%)、纵横比为≥1 (39.2%)、极低回声(41.2%)、微小钙化(49.0%)、无晕(96.1%)、中央为主型血流(54.9%)及淋巴结累计(43.1%)在C-PTC组中更常见。以上特征FVPTC组与C-PTC组结节比较，差异均有统计学意义(P<0.05)。结论 与C-PTC相比，FVPTC有更多良性的超声特征，超声可疑恶性特征的缺乏不能排除FVPTC，需对结节结合多个声像图特征综合判断。
      【关键词】 超声检查；甲状腺乳头状癌；滤泡型；经典型；病理学
      【中图分类号】 R736.1 【文献标识码】 A 【文章编号】 1003—6350（2016）22—3706—04

Ultrasonic appearances and pathological features of follicular variant papillary thyroid carcinomas incomparison with classical papillary thyroid carcinomas.
DAI Ni-na 1, PI Xiao-lan 2, ZHANG Wen-jun 1. 1. Departmentof Ultrasound, the Affiliated Taihe Hospital of Hubei University of Medicine, Shiyan 442000, Hubei, CHINA; 2. Departmentof Ultrasound, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, CHINA
【Abstract】 Objective To investigate the ultrasonic characteristics and pathological findings of follicular vari-ant of papillary thyroid carcinoma (FVPTC) and classical papillary thyroid carcinomas (C-PTC). Methods We re-viewed the ultrasound images of 40 patients with FVPTC (FVPTC group) and 51 patients with C-PTC (C-PTC group)confirmed by surgery and pathology in our hospital from January 2009 to June 2015. The ultrasonic characteristics wereanalyzed retrospectively and compared with pathological results. Results The preoperative correct diagnosis rate ofC-PTC group was significantly higher than that of FVPTC group (85.2% vs 56.1%, P<0.05). Regular shapes (47.5%),well-defined margins (60.0%), isoechoic (52.5%), no calcifications (52.5%), presence of sonographic halo (60.0%),predominantly perinodular color Doppler (42.5%) and without lymph nodes metastasis (70.0%) were more frequentin FVPTC group than C-PTC group. Irregular shape (51.0% ), ill-defined margin (64.7% ), taller-than-wide (39.2% ),marked hypoechogenicity (41.2%), microcalci?cation (49.0%), absence of sonographic halo (96.1%), predominantly in-ternal central color Doppler (54.9%) and with lymph nodes metastasis (43.1%) were more frequent in C-PTC group. Theabove sonographic features showed statistically significant difference between FVPTC group and C-PTC group (P<0.05). Conclusion Compared with C-PTC, FVPTC have more benign sonographic features. The absence of suspiciousmalignant features can not exclude FVPTC, and the diagnosis should be made based on multiple sonographic features.
      【Key words】 Sonography; Papillary thyroid carcinoma; Follicular variant; Classical variant; Pathology·论 著·doi:10.3969/j.issn.1003-6350.2016.22.032