术前彩色多普勒超声血流参数对甲状腺乳头状癌术后预后的预测价值

Predictive Value of Preoperative Color Doppler Ultrasound Blood Flow Parameters for Postoperative Prognosis of Papillary Thyroid Carcinoma

目的 研究术前彩色多普勒超声血流参数对甲状腺乳头状癌(PTC)术后预后的预测价值。方法 选取2019年1月—2021年1月收治的116例PTC,根据预后情况分为预后良好组和预后不良组。所有受试者于手术治疗前行彩色多普勒超声检查,获得病灶部位血流参数。采用多因素Logistic回归分析明确PTC术后患者预后不良的危险因素,绘制受试者工作特征(ROC)曲线评估彩色多普勒超声血流参数对PTC术后预后的预测价值。结果 多因素Logistic回归分析结果显示,甲状腺包膜侵犯、淋巴结转移、甲状腺球蛋白>40μg/L、阻力指数(RI)、搏动指数(PI)、收缩期峰值血流速度(PSV)是影响PTC术后患者预后不良的独立危险因素(P<0.01)。RI、PI、PSV联合预测PTC术后患者预后不良的受试者工作特征曲线下面积、约登指数分别为0.863、61.30%,均高于上述指标单独预测(P<0.01)。结论RI、PI、PSV高水平是影响PTC术后患者预后不良的独立危险因素,预测PTC术后患者预后不良的价值较高,且联合检测的预测价值更高。

Objective To investigate the value of preoperative color Doppler ultrasound blood flow parameters in pre⁃dicting the prognosis of papillary thyroid carcinoma(PTC).Methods In total,116 patients with PTC treated from January 2019 to January 2021 were selected and divided into good prognosis group and poor prognosis group according to the prognosis.All subjects were examined by color Doppler ultrasound before surgical treatment to obtain the blood flow parameters at the le⁃sion site.Multivariate Logistic regression analysis was used to identify the risk factors for poor prognosis after PTC,and receiv⁃er operating characteristic(ROC)curve was drawn to evaluate the predictive value of color Doppler ultrasound blood flow pa⁃rameters for prognosis after PTC.Results Multivariate Logistic regression analysis showed that thyroid capsule invasion,lymph node metastasis,thyroglobulin(TG)>40μg/L,resistance index(RI),pulsation index(PI),and peak systolic blood flow velocity(PSV)were independent risk factors for poor prognosis after PTC(P<0.01).The area under ROC curve and Yoden index of combined detection of RI,PI and PSV in predicting poor prognosis after PTC were 0.863 and 61.30%,respectively,which were higher than those predicted by the above indexes alone(P<0.01).Conclusion High levels of RI,PI and PSV are independent risk factors for poor prognosis of patients after PTC,which have a higher predictive value for poor prognosis in postoperative PTC patients,and the predictive value of combined detection is higher.