【摘要】：目的 :探討甲狀腺微小乳頭狀癌(Papillary thyroid microcarcinoma,PTMC)術(shù)前超聲癌灶特征預(yù)測(cè)頸部中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移的臨床價(jià)值。方法:回顧性分析2014年3月—2015年10月杭州市第一人民醫(yī)院收治的182例PTMC患者的超聲影像及病理資料。采用單因素和多因素Logistic回歸分析術(shù)前超聲癌灶特征與頸部中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移的關(guān)系。結(jié)果:182例PTMC共清掃220側(cè)中央?yún)^(qū)淋巴結(jié),其中88側(cè)中央?yún)^(qū)發(fā)生淋巴結(jié)轉(zhuǎn)移,轉(zhuǎn)移率為40.00%。單因素分析結(jié)果顯示,PTMC超聲癌灶特征如部位、腫瘤最大徑、被膜侵犯及微鈣化與其同側(cè)中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移相關(guān)(均P0.05)。多因素Logistic回歸分析進(jìn)一步顯示,PTMC的超聲癌灶特征如部位、最大徑及被膜侵犯狀況與其中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移密切相關(guān)(均P0.05)。結(jié)論 :PTMC的癌灶超聲特征如病灶部位、腫瘤最大徑及被膜侵犯是術(shù)前預(yù)測(cè)中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移的高危因素。
[Abstract]:Objective: to evaluate the clinical value of preoperative ultrasonographic features of thyroid micropapillary carcinoma (Papillary thyroid microcarcinoma,PTMC) in predicting lymph node metastasis in the central region of the neck. Methods: the ultrasonographic and pathological data of 182 patients with PTMC admitted to the first people's Hospital of Hangzhou from March 2014 to October 2015 were analyzed retrospectively. Univariate and multivariate Logistic regression analysis was used to analyze the relationship between the features of the foci and the lymph node metastasis in the central region of the neck. Results: one hundred and twenty two central lymph nodes were dissected in 182 patients with PTMC, 88 of them had lymph node metastasis in the central region, and the metastasis rate was 40.00. Univariate analysis showed that the location, tumor maximum diameter, membrane invasion and microcalcification were correlated with lymph node metastasis in the ipsilateral central region of PTMC (P0.05). Multivariate Logistic regression analysis further showed that the location, the maximum diameter and the invasion of the capsule were closely related to the lymph node metastasis in the central region of PTMC (P0.05). Conclusion: the ultrasonographic features of PTMC, such as the location of the tumor, the maximum diameter of the tumor and the invasion of the capsule, are the high risk factors for predicting lymph node metastasis in the central region before operation.
【作者單位】： 松陽(yáng)縣人民醫(yī)院超聲科;南京醫(yī)科大學(xué)附屬杭州醫(yī)院(杭州市第一人民醫(yī)院);杭州市腫瘤醫(yī)院超聲科;
【基金】：浙江省公益技術(shù)應(yīng)用研究項(xiàng)目(2017C33180) 浙江省醫(yī)藥衛(wèi)生科技計(jì)劃項(xiàng)目(2015KYB293) 杭州市科技計(jì)劃項(xiàng)目(20131813A08、20163501Y46) 杭州市醫(yī)藥衛(wèi)生科技計(jì)劃項(xiàng)目(2012A020、2014A02、2015A21)聯(lián)合資助
【分類號(hào)】：R445.1;R736.1

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