多模态超声在评估甲状腺微小乳头状癌颈部中央区淋巴结转移中的价值

Value of multimodal ultrasound in predicting cervical central lymph node metastasis of papillary thyroid microcarcinoma

目的:评估多模态超声预测甲状腺微小乳头状癌(PTMC)颈部中央区淋巴结转移的有效性。方法:收集110例PTMC患者的临床指标和多模态超声特征,并与颈部中央区淋巴结转移行单因素及多因素分析。结果:<42岁、男性PTMC患者更易发生颈部中央区淋巴结转移(均P<0.05);结节最大截面横径≥0.52 cm或纵径≥0.66 cm是PTMC发生颈部中央区淋巴结转移的高危因素(均P<0.01);微钙化和弹性评分≥4分的PTMC患者更易发生颈部中央区淋巴结转移(均P<0.01)。多因素分析显示,仅微钙化是PTMC颈部中央区淋巴结转移的独立危险因素。结论:对结节内伴微钙化的PTMC患者,应加强颈部中央区淋巴结的术前评估和术中治疗。

Objective:To evaluate the value of multimodal ultrasound in cervical central lymph node metastasis(CLNM)of papillary thyroid microcarcinoma(PTMC).Methods:Clinical data and ultrasonic features of 110 PTMC patients who underwent thyroid surgery were collected.The risk factors for predicting cervical CLNM were analyzed.Results:Male and age<42 years old were more likely to develop cervical CLNM in PTMC(P<0.05).Transverse diameter≥0.52 cm or longitudinal diameter≥0.66 cm were high-risk factors for cervical CLNM(P<0.01).Microcalcifications and elastic scores≥4 points were more likely to develop central LNM in PTMC(both P<0.01).The multivariate analysis showed that microcalcification was an independent risk factor for cervical CLNM in PTMC.Conclusions:For PTMC patients with microcalcification within the nodules,preoperative evaluation and intraoperative treatment of cervical central lymph nodes should be strengthened.