基于C⁃TIRADS分析甲状腺乳头状癌出现颈部淋巴结转移的影响因素  

Risk factors of cervical lymph nodule metastasis on papillary thyroid carcinoma based on C⁃TIRADS

作　　者：刘承开 张蕾[1] 王晓东[2] LIU Chengkai;ZHANG Lei;WANG Xiaodong(Department of Ultrasound,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,China)

机构地区：[1]广州中医药大学,广州510405 [2]广州中医药大学第一附属医院,广州510405

出　　处：《实用医学杂志》2021年第12期1587-1591,共5页The Journal of Practical Medicine

基　　金：广东省医学科学技术研究基金(编号:B2019050)。

摘　　要：目的2020年8月我国学者发布了符合中国国情的甲状腺影像报告和数据系统(Chinese Thyroid Imaging Reporting and Data System,C⁃TIRADS),由于该系统发布时间不久,它的应用尚未普及。现本研究利用C⁃TIRADS分析甲状腺乳头状癌(papillary thyroid carcinoma,PTC)出现颈部淋巴结转移(cervical lymph nodule metastasis,CLNM)的风险因素,为临床诊断和治疗提供依据。方法回顾性分析本院194例术后病理诊断为PTC的结节,根据PTC是否出现颈部淋巴结转移分为转移组和非转移组,对PTC的C⁃TIRADS评分和颈部淋巴结转移之间的关系进行单因素及多因素logistic回归分析。结果转移组患者C⁃TIRADS评分为4.0(2.0,5.0),高于非转移组患者(P<0.01)。经多因素logistic回归分析提示,PTC的患者性别(OR=0.288,95%CI:0.12~0.689,P=0.005)、年龄(OR=0.964,95%CI:0.936~0.992,P=0.011)和PTC的大小(OR=4.506,95%CI:2.275~8.922,P<0.01)、数量(OR=3.502,95%CI:1.681~7.296,P=0.001)及C⁃TIRADS评分(OR=1.948,95%CI:1.227~3.091,P=0.005)是PTC出现颈部淋巴结转移的独立危险因素。结论PTC的C⁃TIRADS评分联合结节数量和大小及患者的性别、年龄对预测其是否出现颈部淋巴结转移具有重要意义。Objective To study the risk factors of cervical lymph nodule metastasis(CLNM)on papillary thyroid carcinoma(PTC)based on Chinese thyroid imaging report and data system(C⁃TIRADS).Methods A total of 194 patients diagnosed as PTC by surgery and pathological indication were included in the research.All selected participants were divided into lymph nodule metastasis group and lymph nodule negative group respectively accord⁃ing to the presence of CLNM.Then,the relationship between C⁃TIRADS score of PTC and CLNM was analyzed by univariate and multivariate logistic regression analysis.Results The score of C⁃TIRADS was 4.0(2.0,and 5.0)among the patients with CLNM,higher than those without cervical lymph nodule metastasis(P<0.01).Multivariate logistic regression analysis indicated that sex(OR=0.288,95%CI:0.12~0.689,P=0.005),age(OR=0.964,95%CI:0.936~0.992,P=0.011),size(OR=4.506,95%CI:2.275~8.922,P<0.01)and number(OR=3.502,95%CI:1.681~7.296,P=0.001)of the nodule and C⁃TIRADS score(OR=1.948,95%CI:1.227~3.091,P=0.005)were risk factors for CLNM.Conclusion C⁃TIRADS score of PTC combined with patients′sex,age and size and number of the nodule is of great significance in predicting CLNM of PTC.

关 键 词：甲状腺乳头状癌 颈部淋巴结转移 超声 中国甲状腺影像报告和数据系统 

分 类 号：R736.1[医药卫生—肿瘤]