安克侦软件识别甲状腺乳头状癌的超声征象联合临床特征预测颈部淋巴结转移的价值

Value of combination of ultrasonic signs detected by AmCAD-UT and clinical features in predicting cervical lymph node metastasis in patients with papillary thyroid carcinoma

目的 :探讨安克侦软件量化的甲状腺乳头状癌(PTC)的超声征象与发生颈部淋巴结转移的相关性。方法 :收集PTC患者177例,依据手术病理是否有淋巴结转移分为颈部淋巴结转移组71例,非转移组106例。由安克侦软件对2组目标结节最大径、回声类型、内部结构、微钙化、边缘、回声均匀度、纵横比等指标进行分析,并比较2组间各指标及临床资料。结果:2组性别和年龄差异均有统计学意义(均P<0.05)。2组安克侦软件量化的超声征象中结节最大径、微钙化、边缘比较差异均有统计学意义(均P<0.05),纵横比差异无统计学意义(P=0.056)。进一步行多因素二元logistic回归分析,经变量筛选后,患者年龄、性别、结节最大径、微钙化差异均有统计学意义(均P<0.05)。以患者年龄≤45岁、男性、微钙化、结节最大径≥1 cm作为PTC发生颈部淋巴结转移的独立危险因素。logistic回归模型为:logit(P)=-2.631+1.641×年龄+0.879×性别+0.862×微钙化+1.237×结节最大径。结论:安克侦软件量化的PTC超声征象结合患者年龄、性别因素有助于对颈部淋巴结转移作出预警。

Objective:To investigate the correlation between ultrasonic signs quantified by AmCAD-UT detection and cervical lymph node metastasis in papillary thyroid carcinoma(PTC). Methods:A total of 177 cases of PTC were collected,and patients were divided into a cervical lymph node metastasis group(71 cases) and a non-metastasis group(106 cases) according to whether there was lymph node metastasis. Seven signs of the nodules were analyzed by AmCAD-UT detection,including the maximum diameter,echo type,internal structure,microcalcification,edge,internal echo uniformity and aspect ratio. These features of the nodules were compared between the two groups. Results:There were statistically significant differences in sex and age between the two groups(both P<0.05). Among the signs identified by AmCAD-UT detection,nodule maximum diameter,microcalcification and marginal irregularity were statistically significant between the two groups(all P<0.05),while the aspect ration was not statistically significant(P= 0.056). Multivariate binary logistic regression analysis was performed. After variable screening,the age,sex,maximum diameter of nodules and microcalcification were statistically different(all P<0.05). Age of below 45 years old,male,microcalcification and maximum diameter ≥1 cm were independent risk factors for cervical lymph node metastasis in PTC. Logit(P)=-2.631+1.641× age+0.879× sex+0.862× microcalcification+1.237× maximum diameter. Conclusion:The ultrasonic signs quantified by AmCAD-UT detection combined with age and sex can help to predict the metastasis of cervical lymph nodes.