| 摘要: |
| 目的 探讨单灶甲状腺乳头状癌（PTC）临床、二维超声、超声造影特征与中央区淋巴结转移（CLNM）的相关性。方法 回顾性分析2018年1月～2023年2月我院经手术病理证实的符合入、排标准的290例单灶PTC，根据中央区淋巴结有无转移分为有转移组（114例）和无转移组（176例）。纳入相关临床及超声特征，应用单因素及多因素Logistic回归分析，绘制受试者工作特征（ROC）曲线评估效能。结果 单因素分析结果：有转移组与无转移组在性别、年龄、桥本甲状腺炎（HT）、结节大小、成分、回声均匀性、纵横比、微钙化、结节周围甲状腺被膜连续性、增强程度、增强均匀性差异均有统计学意义（均P＜0.05）。 Logistic回归分析结果：男性、年龄＜35岁、结节≥1.00cm、微钙化、结节周围甲状腺被膜中断是单灶PTC患者CLNM的独立危险因素；HT（OR=0.312）是CLNM的保护因素（P＜0.05）。 ROC曲线AUC为0.864（95%CI 0. 823~0.906），灵敏度为86.0%、特异度为76.1%。结论 当单灶PTC患者为男性、年龄＜35岁、结节≥1.00cm、伴微钙化、结节周围甲状腺被膜中断时，CLNM风险增高；HT是CLNM的保护因素。 |
| 关键词: 甲状腺乳头状癌 桥本甲状腺炎 淋巴结转移 |
| DOI： |
| 投稿时间：2023-07-13修订日期：2023-08-20 |
| 基金项目:山西省科技厅社会发展项目,人工智能与超声影像组学对甲状腺癌精准诊断及其侵袭转移的研究 (编号：201903D321190) |
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| The study of the correlation between solitary papillary thyroid carcinoma and it’s central cervical lymph node metastasis |
| FAN Wenwen,CHEN Yaodong,LIU Liping,YAN Xiaohui |
| (the First Hospital of Shanxi Medical University) |
| Abstract: |
| Objective To investigate the correlation between the characteristics of clinic, gray-scale sonography and contrast-enhanced ultrasound of solitary papillary thyroid carcinoma(PTC) and central lymph node metastasis(CLNM). Methods Retrospective analysis of 290 cases of solitary PTC examined by our hospital and confirmed by surgical pathology based on the inclusion and exclusion criteria from January 2018 to February 2023. All cases was divided into the group with metastasis (114 cases) and without metastasis (176 cases) according to the presence or absence of CLNM. Relevant clinical and ultrasound features were recorded, univariate and multivariate logistic regression analyses were applied to analyze the correlation. Meanwhile, receiver operator characteristic (ROC) curve was plotted to assess the efficacy. Results Univariate analysis suggested that gender, age, hashimoto’s thyroiditis(HT), nodule size, composition, echo homogeneity, A/T, microcalcification, perinodular thyroid perineural continuity, enhancement degree and enhancement uniformity were related with CLNM(all P < 0.05). Logistic regression analysis showed that male, less than 35 years old, nodule size larger than 1.00cm, microcalcification and interruption of the perinodular thyroid peritoneum were independent risk factors of CLNM in solitary PTC; HT (OR=0.312) was a protective factor for CLNM(P < 0.05). The AUC of the ROC curve was 0.864 (95% CI 0. 823-0.906), sensitivity 86.0% and specificity 76.1%. Conclusions When patients with solitary PTC are male, less than 35 years, nodule size larger than 1.00 cm, with microcalcifications and interrupted thyroid perineurium, the risk of CLNM is promoted. HT is a protective factor against CLNM. |
| Key words: Papillary thyroid carcinoma Hashimoto’s thyroiditis Lymph node metastasis |
