甲状腺微小乳头状癌原发灶超声特征与颈部淋巴结转移的关系

Correlation Between Sonographic Features of Primary Papillary Thyroid Microcarcinoma and Cervical Lymph Node Metastasis

目的超声对甲状腺微小乳头状癌(PTMC)颈部转移淋巴结的检出率较低,本研究探讨PTMC原发灶超声特征能否预测颈部淋巴结转移,为治疗提供影像学依据。资料与方法选取行超声检查并经手术病理证实的287例PTMC患者,分为淋巴结转移组86例和无转移组201例。回顾性分析两组PTMC原发灶超声特征,探讨其与颈部淋巴结转移的关系。结果单因素分析显示,患者性别、年龄、原发灶形态、微钙化在颈部淋巴结转移与无转移组差异具有统计学意义(P<0.05)。多因素分析显示,患者性别、年龄、原发灶形态、原发灶与包膜接触面积是PTMC患者颈部淋巴结转移的独立影响因素(P<0.05)。结论男性、年龄≤50岁、原发灶形态不规则及其与包膜的接触面积大是PTMC颈部淋巴结转移的独立影响因素,其中原发灶形态不规则的超声特征是预测颈部淋巴结转移的重要指标。PTMC患者原发灶的部分超声特征有助于预测患者颈部淋巴结转移,为治疗提供影像学依据。

Purpose The detection rate of cervical lymph node metastasis in papillary thyroid microcarcinoma（PTMC） is low. The purpose of this study is to investigate the relationship between ultrasonic features of PTMC and presence of cervical lymph node metastasis, providing imaging evidence for treatment. Materials and Methods 287 selected patients with PTMC were confirmed by ultrasound examination and pathology, and divided into lymph node metastasis group（86 cases） and non-metastasis group（201 cases）. The PTMC primary focal ultrasound characteristics of two groups were retrospectively reviewed to explore its relationship with cervical lymph node metastasis. Results Univariate analysis showed that gender, age, ultrasound primary lesion patterns, microcalcification in the cervical lymph node metastasis and non-metastasis group had significant difference（P〈0.05）. Multivariate analysis showed that gender, age, primary lesion patterns, primary foci and capsular contact area were independent influence factors to predict cervical lymph node metastasis in PTMC patients（P〈0.05）. Conclusion Male gender, age ≤ 50 years old, irregular shape of the primary lesion and bigger capsular contact area are independent risk factors of cervical lymph node metastasis in PTMC, with irregular shape being the important index to predict cervical lymph node metastasis. Some ultrasound features of the primary tumor in patients with PTMC are helpful to predict cervical lymph node metastasis, and provide imaging evidence for the treatment.