甲状腺乳头状癌与淋巴结密度相关的临床及超声特征分析

doi:10.16150/j.1671-2870.2019.05.013

摘要/Abstract

摘要：

目的： 探讨甲状腺乳头状癌（papillary thyroid carcinoma,PTC）的临床、超声特征及其与颈淋巴结密度（lymph node density,LND）间的关系。方法：将148例PTC患者分为LND≤0.19组及LND >0.19组,收集患者的临床资料（年龄、性别、是否伴桥本甲状腺炎等）,行灰阶超声检查评估其甲状腺癌结节数目、大小、边缘、内部结构、回声水平、结节内钙化、与甲状腺被膜是否接触等。采用单因素及多因素分析确定上述评估指标与LND间的关系。结果：单因素分析显示,患者的年龄、甲状腺癌结节数目及大小、与甲状腺被膜接触、癌结节钙化与LND有关;Logistic回归分析显示,PTC结节的大小、结节钙化、与甲状腺被膜接触与LND间有相关性。结论： PTC灰阶超声特征在一定程度上可帮助提示LND的高低,对临床制定治疗方案起着指导作用,可以降低患者的复发风险,并改其生存率。

关键词: 甲状腺乳头状癌, 颈淋巴结密度, 灰阶超声

Abstract:

Objective: To investigate the correlation of clinical and gray-scale sonographic features with cervical lymph node density (LND in papillary thyroid carcinoma(PTC). Methods: A total of 148 patients with PTC were divided into 2 groups: LND≤0.19 and LND>0.19. Clinical data of patients(age, gender and Hashimoto thyroiditis) were collected. Number of PTC nodules as well as the size, margin, internal architecture, internal echoes, calcification and contacting with thyroid capsule were evaluated by gray-scale sonography. Single factor analysis and logistic regression analysis were used to evaluate the correlation between the clinical data and LND. Results: Single factor analysis showed that age,number of nodule, size, calcification and contacting with thyroid capsule were correlated with LND. Logistic regression analysis showed that LND was correlated with the nodule size, calcification and contacting with thyroid capsule. Conclusions: Gray-scale sonographic features may indicate the LND level in PTC, which may be helpful for formulating treatment plan to reduce the risk of recurrence and improving survival.

Key words: Papillary thyroid carcinoma, Lymph node density, Gray-scale sonography

中图分类号:

R736.1

余小情, 詹维伟, 周伟, 吴宇, 王怡, 李伟伟, 陶玲玲, 樊金芳. 甲状腺乳头状癌与淋巴结密度相关的临床及超声特征分析[J]. 诊断学理论与实践, 2019, 18(05): 555-559.

YU Xiaoqing, ZHAN Weiwei, ZHOU Wei, WU Yu, WANG Yi, LI Weiwei, TAO Lingling, FAN Jinfang. Analysis of lymph node density related clinical and gray-scale sonographic characteristics of papillary thyroid carcinoma[J]. Journal of Diagnostics Concepts & Practice, 2019, 18(05): 555-559.

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甲状腺癌结节	B	S.E.	Wald	df	Sig.	Exp(B)
结节数目	1.184	0.523	0.113	1	0.129	1.266
结节最大径	1.206	0.443	7.410	1	0.006	3.340
结节纵横比	0.749	0.572	1.711	1	0.838	1.115
结节钙化	1.378	0.480	8.255	1	0.004	3.967
边界与被膜接触	0.836	0.420	3.954	1	0.047	2.306