137例多中心老年甲状腺髓样癌超声特征及其预后的影响因素分析

Ultrasonic Characteristics and Prognostic Factors of 137 Cases of Medullary Thyroid Carcinoma in Multicentre Senile Patients

目的探讨多中心老年甲状腺髓样癌超声特征及其预后的影响因素。方法选取2018年10月—2021年10月四川泌尿外科医院于收治的137例甲状腺髓样癌患者为研究对象,均行彩色超声诊断甲状腺髓样癌特征。采用单因素和多因素分析甲状腺髓样癌相关因素和危险因素。结果甲状腺髓样癌超声特征以低回声、边界清晰、无钙化、内部血流和无囊性变为主。随访36个月甲状腺髓样癌生存118例,死亡19例。单因素分析,两组性别、原发病灶累及、合并高血压、合并糖尿病、甲状包膜侵犯和复发比较,差异无统计学意义(P>0.05)。死亡组原发病灶>4 cm、姑息性手术及远处转移与生存组比较,差异有统计学意义(P<0.05)。多因素分析,原发病灶大小(OR=1.548)、手术彻底程度(OR=2.361)和远处转移(OR=1.769)为影响甲状腺癌髓样癌预后危险因素(P<0.05)。结论多中心老年甲状腺髓样癌超声特征以低回声、边界清晰、无钙化、内部血流和无囊性变为主,其受多因素影响,其中原发病灶大小、手术彻底程度和远处转移为其危险因素。

Objective To explore the ultrasonic characteristics and prognostic factors of multicentre senile medullary thyroid carcinoma.Methods 137 patients with medullary thyroid carcinoma admitted to Sichuan Urology Hospital from October 2018 to October 2021 were selected as the research object,all of whom underwent color ultrasound diagnosis of the characteristics of medullary thyroid carcinoma.Single and multiple factor analysis was used to analyze the related factors and risk factors of medullary thyroid carcinoma.Results The ultrasonic characteristics of medullary thyroid carcinoma were mainly hypoechoic,clear boundary,no calcification,internal blood flow and no cystic change.After 36 months of follow-up,118 patients survived and 19 died of medullary thyroid carcinoma.Univariate analysis showed that there was no significant difference between the two groups in gender,primary lesion involvement,hypertension,diabetes,thyroid capsule invasion and recurrence(P>0.05).There were statistically significant differences in primary lesions>4 cm,palliative surgery and distant metastasis between the death group and the survival group(P<0.05).Multivariate analysis showed that the size of the primary lesion(OR=1.548),the degree of surgical thoroughness(OR=2.361),and distant metastasis(OR=1.769)were risk factors for the prognosis of medullary thyroid cancer(P<0.05).Conclusion The ultrasonic characteristics of multicentre senile medullary thyroid carcinoma are mainly low echo,clear boundary,no calcification,internal blood flow,and no cystic change.It's affected by multiple factors,among which the size of the primary lesion,the degree of surgical thoracotomy,and distant metastasis are the risk factors.