临床淋巴结阴性甲状腺乳头状微小癌与非微小癌的超声特征对比研究

Comparative study on sonographic features of clinical lymph node negative papillary thyroid microcarcinoma and non-microcarcinoma

目的比较临床淋巴结阴性(cN0期)甲状腺乳头状微小癌(PTMC)与非PTMC的超声特征,以提高对cN0期PTMC的诊断能力。方法回顾性分析大连市中心医院2015年1月至2017年12月223例甲状腺乳头状癌患者的临床资料,患者术前超声检查未见颈部淋巴结肿大,均行甲状腺癌根治术治疗。其中,PTMC 143例(肿瘤直径≤1 cm,PTMC组),非PTMC 80例(肿瘤直径>1 cm,非PTMC组)。比较两组甲状腺超声检查结果,包括甲状腺肿物的回声、边界、形态、钙化、后方回声、血流及纵横比。结果两组边界不清、形态不规则和后方回声衰减发生率比较差异无统计学意义(P>0.05)。PTMC组极低或低回声和纵横比≥1发生率明显高于非PTMC组[88.1%(126/143)比67.5%(54/80)和37.8%(54/143)比7.5%(6/80)],钙化、周边或内部血流发生率明显低于非微小癌组[55.9%(80/143)比72.5%(58/80)和49.0%(70/143)比77.5%(62/80)],差异有统计学意义(P<0.01或<0.05)。结论cN0期PTMC与非PTMC的超声图像特征具有一定的差异性。

Objective To compare the sonographic features of clinical lymph node negative(cN0)stage papillary thyroid microcarcinoma(PTMC)and non-PTMC,and improve the early diagnosis of cN0 stage PTMC.Methods The clinical data of 223 patients with papillary thyroid carcinoma from January 2015 to December 2017 in Dalian Municipal Center Hospital were retrospectively analyzed.Preoperative ultrasonography of all patients showed lymph node negative,and all patients received radical thyroidectomy.Among them,PTMC was in 143 cases(tumor diameter≤1 cm,PTMC group),and non-PTMC in 80 cases(tumor diameter>1 cm,non-PTMC group).The sonographic features,including echogenicity,boundary,morphology,calcification,posterior echo attenuation,blood flow and ratio of length and width were compared between 2 groups.Results There were no significant differences in the incidences of unclear boundary,irregular shape and posterior echo attenuation between the two groups(P>0.05).The incidences of extremely low or low echo and ratio of length and width≥1 in PTMC group were significantly higher than those in non-PTMC group:88.1%(126/143)vs.67.5%(54/80)and 37.8%(54/143)vs.7.5%(6/80),the incidences rate of calcification and peripheral or internal blood flow were significantly lower than those in the non-PTMC group:55.9%(80/143)vs.72.5%(58/80)and 49.0%(70/143)vs.77.5%(62/80),and there were statistical differences(P<0.01 or<0.05).Conclusions The ultrasonographic features of cN0 stage PTMC and non-PTMC are different.