| 摘要: |
| 目的 分析甲状腺乳状癌(papillary thyroid carcinoma,PTC)患者颈侧区淋巴结转移(lateral lymph node metastasis,LLNM)的相关危险因子。方法 收集本院2014年1月～2017年1月接受手术治疗的208例PTC患者的病历资料及其肿瘤的声像图资料,就PTC患者中央区淋巴结转移 (central lymph node metastasis ,CLNM)、肿瘤与甲状腺被膜关系、双侧、最大径、多发性、钙化、位置、肿瘤边缘及内部具有丰富血流信号、患者年龄及性别与LLNM之间的关系进行回顾性分析。结果 二项分类Logistic逐步回归分析方法筛选出LLNM的危险因子：CLNM、肿瘤与甲状腺被膜的关系、多发、位于上极、肿瘤边缘及内部具有丰富血流信号,建立回归方程,当预测概率≥0.33时,诊断LLNM的敏感度、特异度分别为92.3%及79.9%,其曲线下面积(area under curve, AUC)值为0.923。当CLNM数目≥3枚时,诊断敏感度、特异度分别为79.7%及91.6%,其AUC值为0.915；当CLNM率≥0.37时,诊断敏感度、特异度分别为87.1%及79.0%,其AUC值为0.882。结论 术前超声检查预评估PTC患者LLNM的发生风险,对指导临床决定是否行治疗性颈侧区淋巴结清扫术具有重要意义。 |
| 关键词: 甲状腺乳头状癌 颈侧区淋巴结转移 超声检查 |
| DOI： |
| 投稿时间：2018-01-29修订日期：2018-01-30 |
| 基金项目: |
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| Researching on the correlation between Ultrasound findings of papillary thyroid carcinoma and lateral lymph node metastasis |
| Yang Ying,Lin Xianfang,Wang Gang |
| (Taizhou Hospital Afficiated Wenzhou Medical University) |
| Abstract: |
| Objective To analyze the related risk factors of lateral lymph node metastasis (LLNM) in papillary thyroid carcinoma (PTC)patients. Methods The medical records and sonographic data of 208 patients with PTC received surgical treatment from January 2014 to January 2017 in our hospital were collected. The relationships between PTC patients LLNM and, the central lymph node metastasis (CLNM), relationship with thyroid membrane, bilateral, maximum diameter, multifocal, calcification, location, age ,gender was analyzed retrospectively.Results Binary logistic stepwise regression analysis show that the CLNM, relationship with thyroid membrane, multifocal, located at the upper pole, rich blood flow signals on the edge and inside of the tumor are the risk factors of LLNM in PTC patients, established regression equation, when the predicted probability of P≥0.33, its diagnostic sensitivity, specificity was 92.2% and 79.7% respectively, the area under the curve (AUC) is 0.923. When the number of CLNM≥ 3, its diagnosis sensitivity, specificity was 79.7% and 91.6% respectively, the AUC is 0.915;the rate of CLNM≥0.37, its diagnosis sensitivity, specificity was 87.5% and 79.0% respectively, the AUC is 0.882 . Conclusions Preoperative assessment of the risk of LLNM in patients with PTC by preoperative ultrasound is of great significance in guiding the clinical decision on the treatment of lateral lymph node dissection. |
| Key words: papillary thyroid carcinoma lateral lymph node metastasis ultrasound examination |
