甲状腺微小乳头状癌颈部中央区淋巴结转移的影响因素  

Impact factors for cervical central lymph node metastasis of papillary thyroid microcarcinoma

作　　者：梅雪 张予腾 王佳雨 姜双全[1] 孙宇[2] 田家玮[1] 冷晓萍[1] MEI Xue;ZHANG Yuteng;WANG Jiayu;JIANG Shuangquan;SUN Yu;TIAN Jiawei;LENG Xiaoping(Department of Ultrasound Medicine,The 2nd Affiliated Hospital of Harbin Medical University,Harbin 150086,China;Department of Thyroid Surgery,The 2nd Affiliated Hospital of Harbin Medical University,Harbin 150086,China)

机构地区：[1]哈尔滨医科大学附属第二医院超声医学科,黑龙江哈尔滨150086 [2]哈尔滨医科大学附属第二医院甲状腺外科,黑龙江哈尔滨150086

出　　处：《中国介入影像与治疗学》2023年第11期680-684,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的观察甲状腺微小乳头状癌(PTMC)颈部中央区淋巴结转移(CLNM)的影响因素。方法回顾性分析230例接受手术治疗的PTMC患者,根据术后病理显示有无颈部CLNM分为CLNM组(n=75)和非CLNM组(n=155);以单因素及多因素分析对比2组患者一般资料、超声及手术所见,筛选PTMC颈部CLNM的相关影响因素,并构建logistic回归模型;绘制受试者工作特征(ROC)曲线评估模型预测PTMC患者存在颈部CLNM的效能。结果组间患者性别、年龄、肿瘤最大径、肿瘤与被膜位置关系及BRAF V600E基因差异均有统计学意义(P均<0.05)。PTMC患者年龄、肿瘤最大径、肿瘤与被膜位置关系及BRAF V600E基因均为PTMC发生颈部CLNM的独立影响因素(P均<0.05);以之构建的模型预测PTMC发生颈部CLNM的曲线下面积(AUC)、敏感度、特异度及准确率分别为0.802、73.33%、77.42%及76.09%。结论患者年龄、肿瘤最大径、肿瘤与被膜位置关系及BRAF V600E基因均为PTMC发生颈部CLNM的独立影响因素。Objective To observe the impact factors of cervical central lymph node metastasis(CLNM)of papillary thyroid microcarcinoma(PTMC).Methods Data of 230 PTMC patients who underwent surgical operation were retrospectively analyzed.The patients were divided into CLNM group(n=75)and non-CLNM group(n=155)according to postoperative pathology.Univariate and multivariate analysis were used to compare the general data,ultrasonic and surgical findings between groups,so as to screen the relevant impact factors of cervical CLNM of PTMC.A logistic regression model was then constructed,and receiver operating characteristic(ROC)curve was drawn to evaluate the predictive efficacy of this model.Results There were significant differences of patient’s gender,age,the maximum diameter of tumor,spacial relations between tumor and capsule,as well as BRAF V600E gene were found between groups(all P<0.05).Patient’s age,the maximum diameter of tumor,spacial relations between tumor and capsule and BRAF V600E gene were all independent impact factors for cervical CLNM of PTMC(all P<0.05).A logistic regression model was constructed based on the above factors,and the area under the curve(AUC),sensitivity,specificity and accuracy was 0.802,73.33%,77.42%and 76.09%.Conclusion Patient’s age,the maximum diameter of tumor,spacial relations between tumor and capsule and BRAF V600E gene were all independent impact factors of cervical CLNM of PTMC.

关 键 词：甲状腺癌 乳头状 淋巴结转移 超声检查 

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