微钙化在甲状腺微小乳头状癌患者中的临床意义

Clinical significance of microcalcification in patients with thyroid micropapillary carcinoma

目的探讨高分辨超声下微钙化在预测甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)和颈淋巴结转移中的临床意义。方法回顾性分析2013年1月~2017年6月首都医科大学附属北京同仁医院头颈外科收治的388例具有完整病例资料的PTMC患者临床超声特征及病理诊断,采用Pearson相关性分析和数据拟合建模分析微钙化、肿瘤最大直径与中央区颈部淋巴结转移的规律。结果 PTMC患者微钙化发生率与肿瘤最大直径成严格的二项式函数关系,PTMC肿瘤直径与颈部中央区淋巴结转移率相关,未发现微钙化与颈部中央区淋巴结转移率相关。结论微钙化在诊断PTMC中的权重与结节最大直径相关,伴有微钙化的直径≤1 cm的甲状腺结节患者,随着结节直径越大PTMC风险越大,更建议细针穿刺。

OBJECTIVE To investigate the clinical significance of microcalcification under high resolution ult rasonog raphy in predicting thyroid mcropapillary carcinoma（PTMC） and cervical lymph node metastasis. MET HODS The clinicaldata of 388 patient swith papillary thyroid micr ocarcinoma were analyzed retrospectively in Beijing Tongren Hospital from Jan 2013 to Jun 2017, which included patients＇ clinical ultrasonographic features and pathological results in this study. Pearson correlation analysis and data fitting modeling were used to analyze the microcalcification, the maximum diameter of the tumor and the cervical lymph node metastasis in the central region. RESULTS The incidence of microcalcification in PTMC patients was closely related to the maximal diameter of the tumor. The tumor diameter of PTMC was related to the lymph node metastasis rate in the central region of the neck, and it was not found that microcalcification was associated with lymph node metastasis in the centralregion of the neck. CONC LUSION T he weig ht of microcalcification in the diagnosis of PTMC is related to the maximum diameter of the nodule. Furthermore, patients with thyroid nodules having a tumor diameter of less than 1 cm, with the larger diameter of tumor nodules, the greater the risk of PTMC, the more recommended fine needle biopsy.