| 摘要: |
| 目的 分析甲状腺乳头状癌（papillary thyroid carcinoma,PTC）的超声声像图特征、BRAF V600E基因检测与右侧喉返神经后方淋巴结（lymph nodes posterior to right recurrent laryngeal nerve,LN-prRLN）转移相关性。
方法 收集分析2016年1月～2019年12月行甲状腺右叶或双叶切除的135例PTC患者的临床资料，根据手术病理分为LN-prRLN转移组和LN-prRLN无转移组。采用单因素和多因素Logistic回归分析方法研究PTC患者原发灶超声声像图特征、BRAF V600E基因及右侧颈侧区淋巴结情况与LN-prRLN转移的相关性。
结果 本组研究中LN-prRLN转移率为21.5%（29/135），右侧颈侧区淋巴结转移率为25.9%（35/135），术前超声可显示右侧颈部第Ⅵ组淋巴结55例。两组患者在年龄、肿瘤最大径、包膜接触或受累、超声显示右侧颈部第Ⅵ组淋巴结、BRAF V600E基因突变和右侧颈侧区淋巴结转移比较差异有统计学意义（均P＜0.05）；性别、是否伴有桥本氏甲状腺炎、肿瘤位置、内部回声、钙化类型、形态比较差异均无统计学意义（均P＞0.05）。多因素Logistic回归分析显示超声可显示右侧颈部第Ⅵ组淋巴结及右侧颈侧区淋巴结转移是LN-prRLN转移的独立相关因素。
结论 当PTC患者存在超声可显示右侧颈部第Ⅵ组淋巴结或右侧颈侧区淋巴结转移，是LN-prRLN转移的高危因素，建议行LN-prRLN清扫术。 |
| 关键词: 超声 甲状腺癌 右侧喉返神经后方淋巴结 |
| DOI： |
| 投稿时间：2020-02-15修订日期：2020-02-25 |
| 基金项目: |
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| Clinical Study of Ultrasound Features in Predicting Lymph Node Metastasis to the Right Recurrent Laryngeal Nerve of Papillary Thyroid Carcinoma |
| chengfang,oudi,xudong |
| () |
| Abstract: |
| Objective To analyze the correlation between the sonographic features of papillary thyroid carcinoma (PTC), the detection of BRAF V600E gene and the metastasis of lymph nodes posterior to right recurrent laryngeal nerve (LN-prRLN).Methods The clinical data of 135 patients with PTC who underwent right lobular or bilobectomy from January 2016 to December 2019 were collected and analyzed. They were divided into LN-prRLN metastasis group and LN-prRLN non-metastatic group according to surgical pathology. Univariate and multivariate Logistic regression analysis were used to study the correlation between the sonographic features of primary tumors, BRAF V600E gene, and lymph nodes in the right cervical region and LN-prRLN metastasis.Results In this group of studies, the metastasis rate of LN-prRLN was 21.5% (29/135), and the rate of lymph node metastasis in the right cervical region was 25.9% (35/135). Preoperative ultrasound showed that the lymph nodes in group VI of the right neck were 55 example. There were statistically significant differences in age, maximum tumor diameter, envelope contact or involvement, and ultrasound showing lymph nodes in the right neck group VI, mutations in the BRAF V600E gene, and lymph node metastases in the right cervical side (all P <0.05). ); There were no significant differences in gender, whether it was accompanied by Hashimoto's thyroiditis, tumor location, internal echo, calcification type, and morphology (all P> 0.05). Multivariate Logistic regression analysis showed that ultrasound could show lymph node metastasis in group Ⅵ of right neck and lymph nodes in right lateral cervical region were independent related factors of LN-prRLN metastasis.Conclusions The presence of ultrasound in PTC patients can show group Ⅵ lymph node metastasis in the right neck or lymph nodes in the right cervical lateral region, which is a high risk factor for LN-prRLN metastasis. LN-prRLN dissection is recommended. |
| Key words: ultrasound papillary thyroid carcinoma lymph nodes posterior to right recurrent laryngeal nerve |
