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1、授予單位代碼10089學號或申請?zhí)?0153418中國圖書分類號R246.81HebeiMedicalUniversity碩士學位論文專業(yè)學位甲狀腺乳頭狀腺癌側頸淋巴結轉移的影響因素分析及其超聲診斷意義研究生：任佳佳導師：景尚華教授專業(yè)：耳鼻咽喉科學二級學院：第四醫(yī)院2018年3月目錄中文摘要········································································································1英文摘要··················
2、······················································································3研究論文甲狀腺乳頭狀腺癌側頸淋巴結轉移的影響因素分析及其超聲診斷意義前言·········································································································5材料與方法········································
3、·····················································5結果·········································································································7附表·······································································································10討論···
4、····································································································15結論·······································································································19參考文獻·····························································
5、··································20綜述甲狀腺乳頭狀腺癌側頸淋巴結轉移診治的研究進展·····················24致謝···············································································································37個人簡歷········································································
6、·······························38中文摘要甲狀腺乳頭狀腺癌側頸淋巴結轉移的影響因素分析及其超聲診斷意義摘要目的：評估超聲在甲狀腺乳頭狀腺癌患者的應用價值，并通過分析甲狀腺乳頭狀腺癌患者側頸淋巴結轉移情況及其影響因素，從而指導臨床。方法：本實驗分析了2015年10月—2017年11月在我科住院的120名甲狀腺乳頭狀腺癌的患者，此120名患者術前常規(guī)行甲狀腺超聲檢查，并標記部分淋巴結，并行甲狀腺全切及側頸清掃術；術后將所切除的組織送病理化驗。按照原發(fā)灶的大?。ó斣l(fā)灶為多個時，選擇直徑最大者），分為三組，分別為d﹤
7、1.0cm（A組）、1.0cm≦d≦2.0cm（B組）、d﹥2.0cm（C組）。分別分析統(tǒng)計對比術前超聲所標記及術后病理確診的淋巴結良惡性情況，判斷超聲診斷的準確率。同時，對每組患者的性別、年齡、單雙側腺葉癌灶、術中所見腫瘤是否腺外侵犯（突破被膜、侵犯周圍組織等）的側頸轉移情況進行統(tǒng)計，從而分析側頸轉移與上述因素的關系。結果：本研究中共研究120名患者，88名行單頸清掃，32名行雙頸清掃，統(tǒng)計術前超聲標記及術后病理對應的側頸部淋巴結158枚，術前超聲懷疑淋巴結陽性的有68枚，陰性90枚；術后病理證實淋巴結陽性82枚，淋巴結陰性76枚。術前超聲
8、與術后病理均提示為陽性的淋巴結有57枚。從而得到超聲在診斷甲狀腺乳頭狀腺癌頸淋巴結轉移的靈敏度69.51%、特異度85.52%、陽性預測值83.82%、陰性預測值7
