增强CT值对桥本氏甲状腺炎合并甲状腺乳头状癌中央区淋巴结转移的诊断价值

Diagnostic value of enhanced CT value in central lymph node metastasis of papillary thyroid carcinoma patients with Hashimoto’s thyroiditis

目的探讨增强CT值对桥本氏甲状腺炎(Hashimoto’s thyroiditis,HT)背景下甲状腺乳头状癌(papillary thyroid carcinoma,PTC)中央区淋巴结转移(central lymph node metastasis,CLNM)的诊断价值。方法回顾性分析经手术及病理证实的209例PTC患者的209枚中央区淋巴结,将其分为HT组与non-HT组,其中HT组淋巴结77枚(52枚阴性和25枚阳性)和non-HT组淋巴结132枚(74枚阴性和58枚阳性)。在增强CT图像上测量淋巴结CT值,通过受试者工作特异度曲线分析增强CT值在两组中的最佳阈值及相应敏感度、特异度。结果两组阳性淋巴结增强CT值分别为(103.2±21.1)Hu和(101.9±25.4)Hu(t=0.23,P>0.05),两组阴性淋巴结增强CT值分别为(72.0±15.8)Hu和(68.5±10.9)Hu(t=-1.38,P>0.05)。HT组与non-HT组增强CT值的曲线下面积分别为0.882和0.918,最佳阈值分别为78.8 Hu和74.7 Hu,相应诊断两组CLNM的敏感度分别为92.0%和91.4%,特异度分别为67.3%和77.0%。结论增强CT值对HT组和non-HT组CLNM均具有较高的诊断效能,且两者诊断效能相近,为早期临床制定个性化治疗方案提供理论依据。

ObjectiveTo explore the diagnostic efficacy of enhanced CT value in central lymph node metastasis(CLNM)of papillary thyroid carcinoma(PTC)with Hashimoto’s thyroiditis(HT).MethodsThe 209 central lymph nodes of 209 patients with PTC confirmed by surgery and pathology were retrospectively analyzed,and they were divided into HT group and non-HT group,including 77 lymph nodes(52 negative and 25 positive)in the HT-PTC group and 132 lymph nodes(74 negative and 58 positive)in the non-HT group.The CT values of lymph nodes were measured on enhanced CT images,and the optimal thresholds and corresponding sensitivity and specificity of enhanced CT values in the two groups were analyzed by the receiver operating characteristic curve.ResultsThe enhanced CT values of metastatic lymph nodes in the two groups were(103.2±21.1)Hu and(101.9±25.4)Hu,respectively(t=0.23,P>0.05),and the enhanced CT values of benign lymph nodes were(72.0±15.8)Hu and(68.5±10.9)Hu,respectively(t=-1.38,P>0.05).The area under the curve of enhanced CT values in the HT group and non-HT group were 0.882 and 0.918,respectively,and the optimal thresholds were 78.8 Hu and 74.7 Hu,respectively,with corresponding sensitivity of 92.0%and 91.4%,and specificity of 67.3%and 77.0%,respectively,for the diagnosis of CLNM in the two groups.ConclusionThe enhanced CT value has high and similar diagnostic efficiency for CLNM in HT group and non-HT group,providing a theoretical basis for the early clinical development of individualized treatment plans.