探讨甲状腺滤泡状癌(FTC)的超声及临床病理学特征。

选择2019年6月15日至2022年12月31日于南京市高淳人医院超声科诊断的17例FTC患者，总结其超声、组织病理以及细针穿刺细胞学(FNAC)检查术后基因检测结果的特征。

17例患者病灶长径为(31.23±15.44)mm。超声检查示所有患者肿块回声不均匀，均无微小钙化灶；76.47%(13/17)患者的超声学特点表现为肿块最大径大于25 mm，88.24%(15/17)的患者肿块可见血流信号，且其中70.59%(12/17)患者肿块内血流信号稀疏，82.35%(14/17)的患者肿块未见周围声晕；患者病灶弹性成像评分为(2.53±0.76)分。组织病理学结果显示所有病例的肿块都侵犯到了包膜及包膜外；免疫组织化学染色结果表明所有病例均为甲状腺转录因子1(TTF)阳性，降钙素阴性。9例患者进行FNAC后基因突变检测，鼠类肉瘤病毒癌基因(BRAF)突变检测均为阴性，其中6例患者进行端粒酶逆转录酶(TERT)基因突变检测，有5例为阳性。

术后病理学检查仍然是诊断FTC的金标准，FNAC术联合分子标志物TERT的检测有助于提高FTC的术前诊断率。

To investigate the ultrasonographic and clinicopathological features of follicular thyroid cancer (FTC).

Seventeen patients diagnosed with FTC in the Ultrasonography Department of Nanjing Gaochun people′s Hospital between June 15, 2019 and December 31, 2022 were included to summarize the characteristics of ultrasonography, histopathology and gene testing results after fine needle aspiration cytology (FNAC) examination.

The lesions in 17 patients had an average length diameter of (31.23±15.44)mm. Uneven echo and no microcalcification were visible on ultrasound. The maximum diameter of the mass exceeded than 25 mm in 76.47% (13/17) of the patients, 88.24% (15/17) of the patients could see the blood signal in the mass, 70.59% (12/17) of the patients had sparse blood signal, and 82.35% (14/17) of the patients had no surrounding sound halo. The patients received a focal elastic imaging score of (2.53±0.76) points. Histopathological findings revealed that the mass had invaded the capsule and extended outside of the capsule in each case. Immunohistochemical analysis showed that all instances were positive for thyroid transcription factor 1 (TTF) and negative for calcitonin. Nine individuals had the post FNAC gene mutation detection, while the B-Raf proto-oncogene serine/threonine kinase (BRAF) mutation was negative. In these patients, 6 patients had telomerase reverse transcriptase (TERT) gene mutation detection, of which 5 were positive.

Postoperative pathological examination is considered the gold standard for the diagnosis of FTC. However, the combination of FNAC and TERT detection can enhance the preoperative diagnostic accuracy of FTC.