甲状腺乳头状癌超声声像图表现与颈部淋巴结转移的相关性

PTC: The correlation between sonographic characteristics of ultrasound and metastasis of cervical lymph node

目的:分析甲状腺乳头状癌(PTC)超声声像图表现与颈部淋巴结转移的相关性。方法:选取在医院行甲状腺癌根治术及颈部淋巴结清扫术的498例PTC患者,根据术后病理结果将其分为转移组(163例)及未转移组(335例)。比较两组间性别、年龄以及超声图像的病灶数目、最大径、纵横比、边缘、是否接触被膜、边界、声晕、内部是否呈低回声、回声是否均匀、钙化及血流等特征是否存在差异,单因素分析特征与颈部淋巴结转移的相关性,多元Logisitic回归分析筛选出与PTC颈部淋巴结转移密切相关的声像图恶性征象。结果:单因素分析患者的性别、年龄,分析病灶数目、最大径、边缘、是否接触被膜、血流、是否含有微钙化与颈部淋巴结转移存在一定的相关性,其差异具有统计学意义(x^2=33.094,x^2=126.566,x^2=127.961,x^2=145.087,x^2=53.757,x^2=6.807;P<0.05)。多元Logisitic回归分析结果:多发病灶、最大径>10.0 mm、边缘不规则、与甲状腺被膜接触、血流丰富是与PTC颈部淋巴结转移密切相关的声像图恶性征象,其相关系数有统计学意义(OR=3.103,OR=3.595,OR=2.822,OR=6.317,OR=2.078;P<0.05)。结论:超声图像特征有助于提高超声对PTC颈部淋巴结转移的检出率,为临床决策提供参考依据。

Objective： To analyze the correlation between sonographic characteristics of ultrasound and metastasis of cervical lymph node of papillary thyroid carcinoma（PTC）. Methods： 498 patients with PTC who once received radical operation of thyroid cancer and cervical lymph node dissection were divided into metastasis group（n=163） and non-metastasis group（n=335） according to results post pathology. Gender, age, the number of lesion, maximum diameter, aspect ratio, margin, whether contacted with tunica, border, halo of ultrasound, whether existed hypoecho in interior, whether the echo was uniform, whether existed difference about some characteristics of calcification and blood flow between the two groups were compared and analyzed. The correlation of characteristics and cervical lymphatic metastasis was analyzed by using single factor analysis, and the malignancy phenomenon of ultrasonogram that was closely relevant with cervical lymph node metastasis of patients with PTC were screened out by using Logistic regression. Results： As the results of single factor analysis, there were a certain correlation between series of factors, such as gender, age, the number of lesion, maximum diameter, margin, whether contacted with tunica, blood flow and whether contained tiny calcification, and cervical lymph node metastasis, and these correlations were significant（x2=33.094, x2=126.566, x2=127.961, x2=145.087, x2=53.757, x2=6.807, P〈0.05）. The results of Logistic regression indicated that these factors, included multi-lesions, maximum diameter more than 10.0 mm, irregular margin, contacted with tunica of thyroid and abundant blood flow, were closely correlative with the malignancy phenomenon of ultrasonogram of cervical lymphatic metastasis of patients with PTC, and their correlation coefficient were significant（OR=3.103, OR=3.595, OR=2.822, OR=6.317, OR=2.078, P〈0.05）. Conclusion： The characteristics of ultrasonogram contributes to increase the detectable rate of ultrasound for cervical lymph node metastasis of patients with PTC, and it can provide reference for clinical decision.