High Frequency Ultrasound And Fine Needle Aspiration Biopsy In The Diagnosis Of Cervical Lymph Node Metastasis From Papillary Thyroid Carcinoma

Background:The thyroid is the largest endocrine gland in the body, plays a critical role in the metabolism of the body. In recent years, the incidence of thyroid malignant tumors has increased, accounting for 1.5% of the total systemic malignant tumor incidence. Papillary thyroid carcinoma is the most common malignant tumor of thyroid, accounted for 80-88%. Despite it is relatively lower malignant, but there are still some cases had peripheral involvement and lung, bones and other distant metastasis, and can even lead to death. And cervical lymph node metastasis is the most common way to transfer. Therefore, early diagnosis of cervical lymph node metastasis from papillary thyroid carcinoma is particularly important. With the development of ultrasonic technology, on examination of lymph node metastasis rate increasing. This study intends to combine the high frequency color Doppler ultrasound and ultrasound guided fine-needle aspiration,to dicuss the evaluation for diagnosis of the cervical lymph node metastasis of papillary thyroid carcinoma.Objectives:To investigate the value of high frequency color Doppler ultrasound (HFCDU) and ultrasound guided fine-needle aspiration biopsy (FNAB) in diagnosis of cervical lymph node metastasis of papillary thyroid carcinoma.Materials and Methods:Select 315 patients of metastatic lymph nodes of papillary thyroid carcinoma which was confirmed by pathology, we compared the pathological diagnosed metastatic lymph node with results detected by high frequency color Doppler ultrasound according its features (loss of lymph hilum, presence of cystic, calcification, disorderly blood flow and round shape) and ultrasound guided fine-needle aspiration biopsy. The data obtained were analyzed using spss 20.0 statistical software, and chi-square test, using P<0.05 as the difference was statistically significant.Results:High frequency color Doppler ultrasound detected 306 target lymph nodes, including 81 metastatic cervical lymph nodes and 225 suspected metastatic cervical lymph nodes. The result of high frequency color Doppler ultrasound found that 306 cervical lymph nodes with loss of lymph node hilum were regarded as target lymph nodes. Of 306 target lymph nodes, cystic change could be seen in 62 lymph nodes, calcification in 85 lymph nodes, disorderly blood flow signals in 75 lymph nodes, and round shape in 81 lymph nodes; 113 lymph nodes were further examined by US-FNAB for diagnosis, and a total of 98 metastatic lymph nodes were diagnosed. The postoperative pathology confirmed the diagnosis that a total of 210 lymph nodes were metastatic.68 of them on the same side in the central area,23 in level II,46 in level III and 31 in level Ⅳ,30 were located in thyroid capsule side,12 were located in the contralateral cervical region. High frequency color Doppler ultrasound diagnosis coincidence rate was 68.6%, US-FNAB combined with HFCDU diagnosis coincidence rate was 96.1%.Conclusion:1. High frequency color Doppler ultrasound in diagnosis of cervical lymph node metastasis of papillary thyroid carcinoma has a high sensitivity, the lymph node metastasis has the characteristic of ultrasonic image.2. The combined diagnosis of HFCDU and US-FNAB is more targeted, which can significantly improve the diagnostic sensitivity and specificity, with considerable diagnostic value.