甲状腺微小乳头状癌的超声图像特征与颈部淋巴结转移的相关性

Correlation between ultrasonic sonogram features of papillary thyroid microcarcinoma and cervical lymph node metastasis

目的分析甲状腺微小乳头状癌(PTMC)超声图像特征与颈部淋巴结转移的关系,探讨超声图像特征对PTMC患者颈部淋巴结转移的预测价值。方法对83例PTMC患者行二维超声检查,分析39例有颈部淋巴结转移和44例无淋巴结转移患者的超声图像特征;应用多因素Logistic回归分析法分析超声图像特征与颈部淋巴结转移之间的关系。结果有颈部淋巴结转移和无淋巴结转移患者在性别、年龄、病灶直径、部位、纵横比、内部钙化类型、与被膜的关系及微钙化是否超出结节等方面比较差异均有统计学意义(均P<0.05);边缘和内部回声比较差异均无统计学意义。多因素Logistic回归分析显示,病灶与被膜的关系与颈部淋巴结转移有关(P<0.05),其余参数均无关。结论超声图像特征对PTMC患者是否发生颈部淋巴结转移具有一定预测价值,当PTMC病灶接触被膜时,应在术中清扫中央区淋巴结。

Objective To investigate the relationship between ultrasonic sonogram features of papillary thyroid microcarcinoma(PTMC)and cervical lymph node metastasis(LNM),and to analyze the predictive value of ultrasonic sonogram features on cervical LNM in PTMC.Methods A total of 83 patients with PTMC were enrolled in this study.The features of ultrasonic sonogram of 39 patients with cervical LNM and 44 patients without LNM were analyzed,and the relationship between the features of ultrasonic sonogram and cervical LNM was observed by multivariate Logistic regression analysis.Results There were significant differeces of Sex,age,lesion diameter,location,aspect ratio,type of internal calcification,relationship with capsule and whether microcalcifications exceed nodules between patients with LNM and without LNM(all P<0.05).The edge and internal echoes were not statistically significant. Multivariate Logistic regression analysis showed that the relationship between lesion and capsule was related to cervical LNM(P<0.05),and the other parameters were not related.Conclusion Ultrasonic sonogram features has certain predictive value for the occurrence of cervical LNM in PTMC patients.When PTMC lesions touch the capsule,central lymph nodes should be removed during operation.