MSCT扫描瘤体与甲状腺被膜接触程度对乳头状癌颈部淋巴结转移的预测价值

The Predictive Value of MSCT Scan on the Degree of Contact Between Thyroid Papillary Carcinoma and Thyroid Capsule for Cervical Lymph Node Metastasis

目的探讨多层螺旋CT(MSCT)扫描甲状腺乳头状癌瘤体与甲状腺被膜接触程度对乳头状癌颈部淋巴结转移的预测价值。方法回顾性分析本院经手术后病理证实单发甲状腺乳头状癌患者159例,其中颈部淋巴结转移(阳性,87例),颈部淋巴结未转移(阴性,72例)。根据瘤体与甲状腺被膜接触程度分为无甲状腺被膜接触组、瘤体与甲状腺被膜接触<1/2组、瘤体与甲状腺被膜接触≥1/2组,采用χ2检验分析颈部淋巴结转移阳性和阴性在各组中的分布差异。结果颈部淋巴结转移阳性和阴性在瘤体与甲状腺被膜接触阳性组和阴性组间差异具有统计学意义(χ^(2)=4.034,P<0.05)。瘤体与甲状腺被膜接触阳性组中,<1/2组和≥1/2组,颈部淋巴结转移阳性和阴性两组间差异具有统计学意义(χ^(2)=6.456,P<0.05)。进一步比较颈部淋巴结转移阳性组,淋巴结转移数目和淋巴结转移率<1/2组和≥1/2组差异无统计学意义(P>0.05)。结论甲状腺乳头状癌瘤体与甲状腺被膜接触程度可以对颈部淋巴结转移是否为阳性进行很好地预测,可以为临床提供重要依据。

Objective To explore the predictive value of MSCT scan on the degree of contact between thyroid papillary carcinoma and thyroid capsule for cervical lymph node metastasis.Methods Retrospective analysis was performed on 159 cases of thyroid papillary carcinoma confirmed by pathology after operation in our hospital,including 87 cases with cervical lymph node metastasis(positive)and 72 cases without cervical lymph node metastasis(negative).According to the degree of contact between the tumor and the thyroid capsule,the tumor was divided into three groups:the group without thyroid membrane contact,the tumor and thyroid membrane contact<1/2 group,and the tumor and thyroid membrane contact≥1/2 group.χ^(2) test was used to analyze the distribution difference between positive and negative cervical lymph node metastasis in each group.Results There was significant difference between positive and negative cervical lymph node metastasis between tumor and thyroid capsule contact positive group and negative group(χ2=4.034,P<0.05).In the positive group of tumor and thyroid capsule contact,<1/2 group and≥1/2 group,the difference between negative and positive cervical lymph node metastasis was statistically significant(χ^(2)=6.456,P<0.05).Further comparison of the number of lymph node metastasis and lymph node metastasis rate in the positive cervical lymph node metastasis group showed no statistically significant difference between<1/2 group and≥1/2 group.Conclusion The contact degree between thyroid papilloma and thyroid capsule can predict the positive or not of cervical lymph node metastasis,and provide an important basis for clinical neck lymph node cleaning.