高频超声在甲状腺乳头状癌中央区淋巴结转移诊断中的价值

VALUE OF HIGH FREQUENCY ULTRASOUND IN DIAGNOSIS OF CENTRALLYMPHNODE METASTASISOF PAPILLARY THYROID CARCINOMA

目的探讨高频超声在甲状腺乳头状癌中央区淋巴结转移诊断中的价值。方法选取2019年1月—2021年1月该院就诊的甲状腺乳头状癌患者130例,给予高频超声检查,分析中央区淋巴结转移和非转移超声特征差异。结果有61例患者141枚中央区淋巴结转移;中央区转移和非转移淋巴结内部低回声、长短径比≥2、内部液化、无微钙化、淋巴门结构不清及血供丰富比例比较差异无统计学意义(P>0.05);转移组患者年龄≥45岁比例、肿瘤最大直径>5.0 mm比例、多发病灶比例和病灶微钙化比例分别为68.85%、65.57%、42.62%和78.69%,明显高于非转移组患者(P<0.05);Logistic回归分析结果显示:肿瘤最大直径>5.0mm、多发病灶及病灶微钙化是中央区淋巴结转移发生的影响因素(OR=1.919、2.190和2.059,P<0.05);Logistic模型预测中央区淋巴结转移的ROC曲线下面积为0.953,灵敏性和特异性分别为90.20%和94.20%。结论高频超声在甲状腺乳头状癌中央区淋巴结转移诊断中有较好的应用价值,值得临床使用。

Objective To investigate the value of high frequency ultrasound in the diagnosis of central lymph node metastasis of papillary thyroid carcinoma. Methods One hundred and thirty patients with papillary thyroid cancer in our hospital from January 2019 to January 2021 were selected, the High frequency ultrasound examination was performed, the difference of ultrasound features between central lymph node metastasis and non metastasis was analyzed. Results There were 141 central lymph nodes metastasis in 61 patients;There was no significant difference in the proportion of hypoechoic lymph nodes, long/short diameter ratio ≥ 2,internal liquefaction, no microcalcification, unclear structure of lymph nodes and abundant blood supply between the central region metastasis and non-metastasis group(P>0.05);The proportion of patients with age ≥45 years old, the proportion of patients with maximum tumor diameter>5.0 mm, the proportion of multiple lesions and the proportion of microcalcification in the metastasis group were 68.85%,65.57%,42.62% and 78.69% respectively, which were significantly higher than those in the non-metastasis group(P<0.05);Logistic regression analysis showed that the maximum diameter of tumor>5.0 mm, multiple lesions and microcalcification were the influencing factors of central lymph node metastasis(OR=1.919,2.190 and 2.059,P<0.05).The area under ROC curve of Logistic model for predict central lymph node metastasis was 0.953,the sensitivity and specificity were 90.20% and 94.20% respectively. Conclusion High frequency ultrasound has good application value in the diagnosis of lymph node metastasis in the central region of thyroid papillary carcinoma and is worthy of clinical use.