恶性BethesdaⅢ类甲状腺结节的临床及超声危险因素研究  

The Study of Clinical and Ultrasonic Risk Factors in Malignant BethesdaⅢThyroid Nodules

作　　者：王承杰 王璐瑶 黄一律 李岩[1] 周旺 邓雪飞 陈永超[1] Wang Chengjie;Wang Luyao;Huang Yilv;Li Yan;Zhou Wang;Deng Xuefei;Chen Yongchao(Department of Ultrasound,The Fist Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Basic Medical College,Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学附属第一医院超声科,合肥市230022 [2]安徽医科大学基础医学院,合肥市230022

出　　处：《中国超声医学杂志》2024年第9期976-979,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨甲状腺BethesdaⅢ类(意义不明的非典型病变)恶性结节的临床及超声危险因素。方法回顾性分析术前细针穿刺活检为BethesdaⅢ类且接受手术的甲状腺结节,根据术后病理结果分为良性与恶性组,采用单因素及多因素Logistic回归分析临床及超声特征与术后病理之间的相关性。结果最终纳入的173例BethesdaⅢ类结节中52例(30%)为良性,121例(70%)为恶性,最常见的癌症类型是甲状腺乳头状癌。在多因素Logistic回归分析中,患者年龄≤50岁、微钙化及纵横比>1为BethesdaⅢ类结节恶性独立危险因素(P<0.05)。结论BethesdaⅢ类甲状腺结节具有较高的恶性率,其中,患者年龄≤50岁,超声特征中微钙化及纵横比>1为BethesdaⅢ类甲状腺结节恶性的独立危险因素。Objective To determine the clinical and ultrasonographic risk factors related to malignancy of Bethes-daⅢthyroid nodules(atypia of uncertain significance).Methods Patients with BethesdaⅢthyroid nodule diagnosed by preoperative fine needle aspiration biopsy who underwent surgery were retrospectively enrolled and divided into be-nign and malignant group according to postoperative pathological results.The association between clinical/sonographic features and postoperative pathology were evaluated by univariate and multivariate analysis.Results A total of 173 nodules were included,52(30%)were benign and 121(70%)were malignant.The most frequent type of cancer was papillary thyroid carcinoma.Multivariate analysis confirmed that patient age,microcalcification and aspect ratio>1 were independent risk predictors for malignant nodule(P<0.05).Conclusions BethesdaⅢthyroid nodules have a high malignant rate,among which the age of patients≤50 years,microcalcifications and aspect ratio>1 in ultrasound features are independent risk predictors for malignant Bethesda m thyroid nodules.

关 键 词：超声检查 甲状腺结节 甲状腺细胞病理学Bethesda报告系统 良、恶性 甲状腺乳头状癌 

分 类 号：R736.1[医药卫生—肿瘤] R581[医药卫生—临床医学] R445.1