单发甲状腺乳头状癌CT联合临床特征对中央组淋巴结转移的预测价值

The value of CT signs in combination with clinical materials of single papillary thyroid carcinoma to pre- dict the central lymph node metastasis

目的探讨单发PTC的CT联合临床特征对中央组淋巴结转移（centrallymphnodemetastasis，CLNM）的预测价值。方法回顾经手术和病理证实的366例单发PTC的CT征象及临床资料，采用单因素和多因素logistic回归分析瘤体位置、甲状腺边缘接触情况、钙化、平扫及增强后边界、肿瘤大小、年龄、性别与中央组淋巴结转移的关系。结果366例PTC中，中央组淋巴结转移阳性和阴性分别为155例和211例。单因素和多因素logistic回归分析均表明甲状腺边缘接触、直径、年龄和性别与中央组淋巴结转移相关，其中甲状腺边缘接触、直径〉1．0cm、年龄〈45岁和男性在中央组淋巴结转移中更常见（心0．05）。瘤体位置、钙化、平扫边界、增强后边界与中央组淋巴结转移无关（P〉0．05）。结论甲状腺边缘接触、直径〉1．0cm、年龄〈45岁和男性是CLNM阳性的独立风险因素。

Objective To investigate the value of CT signs in combination with clinical materials of pap- illary thyroid carcinoma （PTC） to predict the central lymph node metastasis （CLNM）. Methods This article reviewed the CT signs and clinical materials of 366 patients with surgically and pathologically verified PTC. The single factor and multi-factor logistic regression analyses were performed on the relation of tumor position, thyroid marginal contact, calcification, plain scan border, border after enhancement, diameter, age and sex with CLNM. Results Among the 366 patients with PTC, the number of patients with positive CLNM and negative CLNM was 155 and 211 respectively. The single factor and multi-factor logistic regression analysis indicated that the thyroid marginal contact, diameter, age and sex were related with CLNM, and the more common patients diagnosed with CLNM had the following features： thyroid marginal contact, a diameter 〉1.0 cm, age 〈45 years and males （P〈 0.05）. Among the single risk factors, the tumor position, calcification, plain scan border and border after en- hancement were unrelated with CLNM （P〉0.05）. Conclusion The thyroid margin contact, diameter〉1.0 cm, age〈45 years and males are independent risk factors in diagnosis of positive CLNM.