超声特征预测cNO甲状腺乳头状癌合并淋巴细胞性甲状腺炎中央区淋巴结转移  

Ultrasound Features Predict Central Lymph Node Metastasis in cNO Papillary Thyroid Cancer Combined with Lymphocytic Thyroiditis

作　　者：邱睿 黄春旺[1] 丛淑珍[1] Qiu Rui;Huang Chunwang;Cong Shuzhen(Department of Ultrasound,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Science,Guangzhou 510080,China)

机构地区：[1]广东省人民医院(广东省医学科学院)超声科,广州市510080

出　　处：《中国超声医学杂志》2023年第2期124-128,共5页Chinese Journal of Ultrasound in Medicine

基　　金：广州市科技计划项目(No.202002030235)。

摘　　要：目的 探讨基于术前超声图像特征预测甲状腺乳头状癌(PTC)合并慢性淋巴细胞性甲状腺炎(CLT)临床淋巴结阴性(cNO)患者中央区淋巴结转移(CLNM)的价值。方法 回顾性分析136例接受甲状腺外科手术的CLT合并PTC、术前超声提示cNO病例,根据术后病理结果是否存在CLNM分为转移组和非转移组;对比两组术前超声图像特征,观察各因素及其联合模型预测中央区淋巴结转移的价值。结果 cNO PTC合并CLT患者中央区淋巴结转移与肿瘤直径、微钙化、内部血流、被膜接触状态有关;多因素Logistic回归分析显示肿瘤直径≥1 cm、微钙化、后被膜接触是cNO PTC合并CLT患者CLNM的独立危险因素;基于Logistic回归结果,三因素预测cNO PTC合并CLT CLNM的AUC分别为0.670、0.624、0.683,其联合预测CLNM的AUC为0.859。结论 术前超声特征可能有效预测cNO状态下PTC合并CLT患者CLNM,对该类患者进行预防性淋巴结清扫可能有利于预后。Objective To investigate the value of preoperative ultrasound image features in predicting lymph node metastasis in the central cervical region(cNO) patients with chronic lymphadenoid thyroiditis(CLT) combined with papillary thyroid carcinoma(PTC). Methods A retrospective analysis was performed on 136 patients with CLT combined with PTC who underwent thyroid surgery with preoperative ultrasound suggestive of cNO. The patients were divided into metastatic group and non-metastatic group according to the postoperative pathological results. The preoperative ultrasound image characteristics of the two groups were compared, and the value of each factor and its combined model in predicting central lymph node metastasis was observed. Results The central lymph node metastasis in patients with CLT combined with PTC was related to tumor diameter, microcalcification, internal blood flow, and peritumoral contact status. Multivariate logistic regression analysis showed that tumor diameter ≥1 cm, microcalcification, and peritumoral contact were independent risk factors for the occurrence of lymph node metastasis in the central cervical region in patients with CLT combined with PTC. Based on the results of logistic regression, the AUC of three factors predicting cervical lymph node metastasis in CLT combined with PTC was 0. 670, 0.624, and 0.683 respectively, and the AUC of their combined prediction of cervical lymph node metastasis was 0.859. Conclusions Preoperative ultrasound features may effectively predict cervical lymph node metastasis in patients with PTC and CLT in cNO state, and preventive lymph node dissection may be beneficial to the prognosis of such patients.

关 键 词：超声检查 甲状腺乳头状癌 慢性淋巴细胞性甲状腺炎 临床淋巴结阴性 中央区淋巴结转移 

分 类 号：R581.4[医药卫生—内分泌] R445.1[医药卫生—内科学] R736.1[医药卫生—临床医学]