多模态超声预测甲状腺乳头状癌颈部中央区淋巴结转移的价值研究

The Value of Multimodal Ultrasound in Predicting Lymph Node Metastasis in the Central Neck Region of Thyroid Papillary Carcinoma

摘要: 目的：探讨多模态超声在预测甲状腺乳头状癌颈部中央区淋巴结转移中的应用价值。方法：选取在我院就诊且病理证实为甲状腺乳头状癌的患者103例。根据颈部中央区淋巴结病理结果分为转移组和未转移组。采用单因素及多因素逻辑回归分析甲状腺乳头状癌的多模态超声图像特征与CLNM之间的关系，并绘制ROC曲线评估诊断效能。结果：单因素及多因素逻辑回归分析显示，男性、多灶性、微钙化、被膜侵犯及等–高增强是预测CLMN的危险因素(P < 0.05)。五者联合的诊断模型预测效能优于各因素单独预测(P < 0.05)。结论：男性、多灶性、微钙化、被膜侵犯及等–高增强是PTC患者CLNM的危险因素，五者联合时诊断效能较好，可为临床制定治疗方案及评估预后提供客观依据。

Abstract: Objective: To explore the value of multimodal ultrasound in predicting lymph node metastasis in the central region of the neck of thyroid papillary carcinoma. Methods: 103 patients with thyroid papillary carcinoma confirmed by pathology were selected. According to the pathological results of lymph nodes in the central region of the neck, they were divided into metastatic group and non- metastatic group. The relationship between the features of multimodal ultrasound images of thy-roid papillary carcinoma and CLNM was analyzed by single factor and multiple factor logistic re-gression, and the ROC curve was drawn to evaluate the diagnostic efficacy. Results: Univariate and multivariate logistic regression analysis showed that male, multifocal, microcalcification, capsule invasion and iso-high enhancement were risk factors for predicting CLMN (P < 0.05). The predictive efficiency of the diagnostic model combined with the five factors was better than that of each factor alone (P < 0.05). Conclusion: Male, multifocal, microcalcification, capsule invasion and iso- high en-hancement are the risk factors of CLNM in PTC patients. The combination of the five can provide an objective basis for clinical treatment planning and evaluation of prognosis.