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find Author "徐书杭" 2 results
  • 甲状腺混合性髓样-乳头状癌伴混合性淋巴结转移1例报道并文献复习

    目的回顾1例甲状腺混合性髓样-乳头状癌伴混合性淋巴结转移患者的诊治经过,结合国内外文献对本病的诊疗进行总结,以期为临床诊治提供一定的参考。方法回顾分析该患者的临床资料、病理切片特征以及免疫组织化学染色结果。在中英文数据库对该类病例进行检索,结合既往文献病例进行分析讨论,总结本病的特征。结果该例患者术前血清降钙素和癌胚抗原均升高,行甲状腺全切除加双侧中央区及颈侧区淋巴结清扫术,术后降钙素和癌胚抗原较术前明显下降。随访半年,一般情况良好。总结文献报道病例资料,提示甲状腺混合性髓样-乳头状癌发病以中老年患者为主,多以颈部无痛性结节为主要临床表现,多数病例有血清降钙素与癌胚抗原升高,病理学上以髓样癌与乳头状癌混合存在为主要特征,以髓样癌成分占比较高较为多见。治疗上以甲状腺全切除术为主要手段,后续治疗需监测血清降钙素、癌胚抗原、甲状腺球蛋白以及综合影像学改变,放射性碘治疗可根据自身病情特点酌情选择。本病总体预后较好。结论甲状腺混合性髓样-乳头状癌发病罕见,在前期诊断时应尽量完善降钙素和癌胚抗原的检查,减少漏诊的可能;穿刺辅以免疫组织化学检测有一定的诊断价值;规范的外科手术是治疗的最佳手段,准确的病理学分类以及不同类型肿瘤细胞占比有助于指导术后治疗。

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  • Diagnostic significance of fine needle aspiration cytology combined with BRAFV600E gene detection in cervical lymph node metastasis of thyroid cancer

    Objective To investigate the diagnostic significance of fine needle aspiration cytology (FNAC) combined with BRAFV600E gene detection in the diagnosis of cervical lymph node metastasis of thyroid cancer. Methods Atotal of 140 patients with suspected cervical lymph node metastasis of thyroid cancer were collected as the research objects, and all patients were given ultrasound-guided FNAC and detection of BRAFV600E gene. The significance of the diagnosis was analyzed according to the gold standard after pathological examination. Results All the 140 patients underwent surgical treatment. For FNAC, the sensitivity was 63.6% (84/132), the specificity was 100% (8/8), the accuracy was 65.7% (92/140), the positive predictive value was 100% (84/84), and the negative predictive value was 14.3% (8/56). For detection of BRAFV600E gene, the sensitivity was 84.8% (112/132), the specificity was 100% (8/8), the accuracy was 85.7% (120/140), the positive predictive value was 100% (112/112), and the negative predictive value was 28.5% (8/28). For FNAC combined with BRAFV600E gene detection, the sensitivity was 90.9% (120/132), the specificity was 100% (8/8), the accuracy was 91.4% (128/140), the positive predictive value was 100% (120/120), and the negative predictive value was 40.0% (8/20). The area under curve of receiver operating characteristic for FNAC, detection of BRAFV600E gene, and FNAC combined with BRAFV600E gene detection were 0.818, 0.924, and 0.955, respectively. Conclusion FNAC combine with BRAFV600E gene detection improves the accuracy of neck lymph node metastasis in patients with thyroid cancer, which is worthyof performed.

    Release date:2018-09-11 11:11 Export PDF Favorites Scan
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