超声评估甲状腺微小癌颈部淋巴结转移的特征及相关危险因素分析  

Ultrasonographic evaluation of cervical lymph node metastasis in thyroid microcarcinoma and analysis of risk factors

作　　者：昃亮[1] 周恒[1] 张晴 Ze Liang;Zhou Heng;Zhang Qing(Department of Ultrasonography,Dezhou People's Hospital,Dezhou 253000,China)

机构地区：[1]德州市人民医院超声科,253000

出　　处：《国际医药卫生导报》2019年第11期1780-1783,1815,共5页International Medicine and Health Guidance News

摘　　要：目的 通过超声评估甲状腺微小癌(TMC)颈部淋巴结转移(CLNM)的特征,并进一步分析影响CLNM的相关危险因素。方法 选取2015年10月至2018年12月于本院住院治疗的183例TMC患者作为研究对象,均经手术病理证实。根据有无淋巴结转移将患者分为CLNM组(n=56)及无CLNM组(n=127),对比分析两组超声图像特征,并采用二元logistic回归分析影响TMC患者发生CLNM的相关危险因素。结果 183例TMC患者中共发现203个病灶,术后病理发现存在CLNM的56例(63个病灶),无CLNM的127例(140个病灶);以病理结果为金标准,超声对CLNM的诊断特异度为96.06%,诊断符合率为72.68%;CLNM与无CLNM的TMC患者的年龄、肿瘤最大径、肿瘤形态、有无钙化者占比差异均有统计学意义(均P<0.05);logistic回归分析结果显示:影响TMC患者发生CLNM的危险因素有年龄<55岁、肿瘤最大径≥0.5cm、不规则肿瘤形态(P<0.05)。结论 超声对CLNM的诊断特异度较高,临床需重点关注肿瘤最大径≥0.5 cm、形态不规则的中青年TMC患者,并给予对应治疗,以控制CLNM的发生率。Objective To evaluate the characteristics of cervical lymph node metastasis(CLNM)in thyroid microcarcinoma(TMC)by ultrasonography,and to further analyze the related risk factors affecting CLNM.Methods 183 TMC patients hospitalized in our hospital from October,2015 to December,2018 were selected as study objects,and were confirmed by surgery and pathology.According to lymph node metastasis,the patients were divided into a CLNM group(n=56)and a no CLNM group(n=127).The ultrasonographic features of the two groups were analyzed,and the risk factors of CLNM in the TMC patients were analyzed by binary logistic regression analysis.Results A total of 203 lesions were found in the 183 TMC patients;56 cases(63 lesions)of CLNM and 127 cases(140 lesions)without CLNM were found by pathology after operation.With pathological results as the gold standard,the diagnostic specificity of ultrasound for CLNM was 96.06%and the diagnostic coincidence rate was 72.68%.There were significant differences in age,tumor maximum diameter,tumor morphology,and calcification between the two groups(all P<0.05).The results of logistic regression analysis showed that the risk factors of CLNM in the TMC patients were<55 years old,tumor maximum diameter≥0.5 cm,and irregular tumor shape(all P<0.05).Conclusions Ultrasound has a high diagnostic specificity for CLNM.In clinical work,attention should be paid to young and middle-aged TMC patients with irregular shape and maximum diameter of tumors(≥0.5 cm)and corresponding treatment should be given to control the incidence of CLNM.

关 键 词：超声 微小癌 甲状腺 淋巴结转移 颈部 危险因素 

分 类 号：R736.1[医药卫生—肿瘤] R445.1[医药卫生—临床医学]