甲状腺恶性结节包膜接触面积与颈部淋巴结转移的相关性研究

Correlation between capsular contact area of thyroid malignant nodules and cervical lymph node metastasis

目的探讨超声评估甲状腺恶性结节包膜接触面积与颈部淋巴结转移的相关性。方法回顾性分析2020年5月至2022年3月于浙江大学医学院附属浙江医院行甲状腺恶性结节手术的115例患者的临床资料,患者术前均行常规超声检查,评估结节与包膜的接触面积,对照术后病理诊断结果,分析甲状腺恶性结节包膜接触面积、结节大小、结节部位与颈部淋巴结转移的相关性。结果115例患者中,甲状腺恶性结节与包膜接触93例。甲状腺恶性结节与包膜接触患者的颈部淋巴结转移率显著高于结节未与包膜接触者(P<0.001);甲状腺恶性结节不同包膜接触面积的患者颈部淋巴结转移率比较差异有统计学意义(P<0.001),接触面积越大,颈部淋巴结转移率越高;颈部淋巴结转移患者结节最大径>1cm的比例显著高于无颈部淋巴结转移者(P<0.05);不同位置与包膜接触的甲状腺恶性结节的颈部淋巴结转移率比较差异无统计学意义(P>0.05)。结论甲状腺恶性结节包膜接触面积与颈部淋巴结转移有相关性,包膜接触面积越大,发生颈部淋巴结转移的概率越高;甲状腺恶性结节越大,结节包膜接触后,发生颈部淋巴结转移的概率越高。

Objective To investigate the correlation between capsule contact area and cervical lymph node metastasis in malignant thyroid nodules assessed by ultrasound.Methods The clinical data of 115 patients who underwent surgery for malignant thyroid nodules in Affiliated Zhejiang Hospital,Zhejiang University School of Medicine from May 2020 to March 2022 were retrospectively analyzed.All patients underwent routine ultrasound examination before surgery to evaluate the contact area between nodules and capsule,and the postoperative pathological diagnosis results were compared.To analyze the correlation between capsule contact area,nodule size,nodule location and cervical lymph node metastasis of thyroid malignant nodules.Results Among 115 patients,93 patients had contact with the thyroid capsule.The area of cervical lymph node metastasis in patients with malignant thyroid nodules in contact with capsule was significantly higher than that in those without(P<0.001).There were statistically significant differences in cervical lymph node metastasis areas among patients with different capsule contact areas(P<0.001).The greater the contact area,the higher the cervical lymph node metastasis area.Patients with cervical lymph node metastasis had a significantly higher proportion of nodules with maximum diameter>1cm than those without cervical lymph node metastasis(P<0.05).There was no significant difference in the area of cervical lymph node metastasis between different positions of thyroid malignant nodules contacting the capsule(P>0.05).Conclusion The contact area of thyroid malignant nodules is correlated with cervical lymph node metastasis.The higher the contact area of thyroid malignant nodules,the higher the probability of cervical lymph node metastasis.The larger the thyroid malignant nodule,the higher the probability of cervical lymph node metastasis after contact with nodule capsule.