CAJ | 학술논문

目的：探讨原发于峡部甲状腺乳头状癌（PTC）超声声像图特征。方法回顾性分析41例病理证实为原发于峡部PTC患者的超声表现，并随机选取同时期原发于侧叶PTC患者90例进行对照，比较两组患者超声表现差异，所有患者均在行超声检查后2周内行甲状腺全切及颈部中央区淋巴结清扫术。结果峡部与侧叶PTC患者在年龄、性别及病灶大小方面相匹配，无明显差别；两组病例在肿块边界、内部回声、微钙化等超声特征之间差异均无统计学意义（P＞0.05）；与原发于侧叶PTC相比，峡部PTC常易表现为甲状腺被膜侵犯、纵横比＜1、颈部中央区淋巴结转移，两组差别均有统计学意义（P＜0.05）。结论与侧叶PTC相比，峡部PTC更易于发生被膜侵犯及颈部中央区淋巴结转移，对于即使边界较清、纵横比＜1的甲状腺峡部结节仍须仔细观察排除恶性结节的可能，提高诊断的准确率。
목적：탐토원발우협부갑상선유두상암（PTC）초성성상도특정。방법회고성분석41례병리증실위원발우협부PTC환자적초성표현，병수궤선취동시기원발우측협PTC환자90례진행대조，비교량조환자초성표현차이，소유환자균재행초성검사후2주내행갑상선전절급경부중앙구림파결청소술。결과협부여측협PTC환자재년령、성별급병조대소방면상필배，무명현차별；량조병례재종괴변계、내부회성、미개화등초성특정지간차이균무통계학의의（P＞0.05）；여원발우측협PTC상비，협부PTC상역표현위갑상선피막침범、종횡비＜1、경부중앙구림파결전이，량조차별균유통계학의의（P＜0.05）。결론여측협PTC상비，협부PTC경역우발생피막침범급경부중앙구림파결전이，대우즉사변계교청、종횡비＜1적갑상선협부결절잉수자세관찰배제악성결절적가능，제고진단적준학솔。
Objective The aim of the present study was to analyze the sonographic features of papillary thyroid carcinoma (PTC) originating in the thyroid isthmus. Methods From January 2012 to December 2014, 41 patients with pathologically confirmed PTC originated in the thyroid isthmus were retrospectively analyzed. As a control group, 90 patients diagnosed as PTC originating in thyroid lobes during the same period were randomly matched to the study patients for age, sex, and tumor size. All patients had undergone total thyroidectomy with bilateral central lymph node dissection. The Chi-square test and rank sum test were used to compare the different ultrasound characteristics between the two groups. Results Compared with PTC located in thyroid lobes, the tumors originating in the isthmus more frequently had a wider-than-tall shape and higher rates of capsular invasions, cervical central lymph nodes metastasis. There were no significant differences among characteristics of the primary tumor echo pattern, microcalcification and boundary between PTC located in isthmus and lobes. Conclusion PTCs originating in the isthmus were more likely to have capsular invasions and cervical central lymph nodes metastasis than those originating in the lobes. Despite the tumors locating in thyroid isthmus have a relatively circumscribed margin with a wider-than-tall shape, more careful ultrasound evaluation should be performed to exclude the possibility of malignant masses.