摘要
目的:探讨单发甲状腺乳头状癌(papillary thyroid carcinoma,PTC)强回声分类与侧颈部淋巴结转移的关系。方法:回顾性分析2014年1-12月在复旦大学附属肿瘤医院就诊并手术的475例单发PTC患者,将其分为侧颈部淋巴结转移阳性组和阴性组。术前超声均提示病灶内伴有强回声,将其强回声模式分为5类:局部点状强回声、弥漫点状强回声、粗大强回声、混合型强回声、周边弧形或蛋壳样强回声。同时纳入相关临床和超声特征,采用单因素和多因素Logistic回归分析确认其与侧颈部淋巴结转移的关系。结果:475例患者中,70例伴有侧颈部淋巴结转移。单因素分析显示,年龄、术前人甲状腺球蛋白(HTG)水平、最大径、位置、强回声分类与侧颈部淋巴结转移有相关性(P<0.05);多因素Logistic回归分析显示,弥漫点状强回声、年龄≤35岁、最大径>10 mm、位于甲状腺上部是侧颈部淋巴结转移的独立危险因素。结论:当单发PTC内出现弥漫点状强回声、患者年龄≤35岁、最大径>10 mm、位于甲状腺上部时容易发生侧颈部淋巴结转移。
Objective To study the correlation between echogenic foci pattern of papillary thyroid carcinoma(PTC)solitary nodule and lateral cervical lymph node metastasis.Methods The clinical data of 475 patients with echogenic foci in preoperative ultrasound and pathologically confirmed PTC solitary nodule from January to December 2014 in Fudan University Shanghai Cancer Center were retrospectively analyzed,which was categorized into lateral cervical lymph node metastasis group and lateral cervical lymph node non-metastasis group.Echogenic foci was classified into five types:local punctate echogenic foci,diffused punctate echogenic foci,coarse echogenic foci,mixed echogenic foci,peripheral annular and eggshell echogenic foci.The related clinical characteristics and the ultrasonic features were also involved.Chi-Square test and Logistic regression analysis were performed to analyze the correlation.Results Age,preoperative human thyroglobulin(HTG)level,maximum diameter,location and echogenic foci pattern distributed to lateral cervical lymph node metastasis of PTC solitary nodule in 475 cases,according to univariate analysis(P<0.05).Multivariate Logistic regression analysis showed diffused punctate echogenic foci,age≤35 years old,maximum diameter>10 mm and upper part were risk factors of lateral cervical lymph node metastasis of PTC solitary nodule.Conclusions Diffused punctate echogenic foci in PTC solitary nodule,patients younger than 35 years old,maximum diameter larger than 1 cm and nodule location at upper part of the thyroid promote to lateral cervical lymph node metastasis.
作者
刘雅静
陈雅玲
王芬
高毅
李佳伟
周瑾
常才
陈敏
周世崇
Liu Yajing;Chen Yaling;Wang Fen;Gao Yi;Li Jiawei;Zhou Jin;Chang Cai;Chen Min;Zhou Shichong(Department of Ultrasound,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032)
出处
《中华超声影像学杂志》
CSCD
北大核心
2020年第7期597-601,共5页
Chinese Journal of Ultrasonography
基金
上海市科学技术委员会引导项目(17411963300)
国家自然科学基金(81401422)
上海申康医院发展中心项目(SHDC22015016)
上海市卫生计生委青年课题(20174Y0011)。
关键词
超声检查
甲状腺乳头状癌
强回声
淋巴结转移
Ultrasonography
Papillary thyroid carcinoma
Echogenic foci
Lymph node metastasis