目的：探讨甲状腺微小乳头状癌（Papillary thyroid microcarcinoma，PTMC）术前超声癌灶特征预测颈部中央区淋巴结转移的临床价值。方法：回顾性分析2014年3月—2015年10月杭州市第一人民医院收治的182例PTMC患者的超声影像及病理资料。采用单因素和多因素Logistic回归分析术前超声癌灶特征与颈部中央区淋巴结转移的关系。结果：182例PTMC共清扫220侧中央区淋巴结，其中88侧中央区发生淋巴结转移，转移率为40.00%。单因素分析结果显示，PTMC超声癌灶特征如部位、肿瘤最大径、被膜侵犯及微钙化与其同侧中央区淋巴结转移相关（均P<0.05）。多因素Logistic回归分析进一步显示，PTMC的超声癌灶特征如部位、最大径及被膜侵犯状况与其中央区淋巴结转移密切相关（均P<0.05）。结论：PTMC的癌灶超声特征如病灶部位、肿瘤最大径及被膜侵犯是术前预测中央区淋巴结转移的高危因素。
Abstract
Objective: To evaluate the clinical significance of preoperative US features of papillary thyroid microcarcinoma(PTMC) predicting central compartment lymph node metastases(CCLNM). Methods: The sonographic features of 182 patients with pathologically confirmed PTMC in Hangzhou First People’s Hospital from March 2014 to October 2015 were retrospectively reviewed. The relationship between ultrasound characteristics of PTMC and CCLNM was analyzed by univariate analysis and logistic regression analysis. Results: The ipsilateral central lymph nodes from 220 sides were dissected in 182 cases of PTMC, of which 88 side of central lymph nodes were metastasis, so the rate of lymph node metastasis was 40%. Univariate analysis revealed that CCLNM was associated with certain preoperative US features, which included lesion location, tumor size, capsule invasion and microcalcification. Moreover, Logistic regression analysis only showed that the preoperative US features of lesion location, tumor size and capsule invasion were independent factors correlated with CCLNM. Conclusions: The lesion location, tumor size and capsule invasion determined by preoperative ultrasound in PTMC are positively correlated with CCLNM.
关键词
甲状腺肿瘤；癌 /
乳头状；淋巴转移；超声检查
Key words
Thyroid neoplasms /
Carcinoma, papillary /
Lymphatic metastasis /
Ultrasonography
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基金
浙江省公益技术应用研究项目（2017C33180），浙江省医药卫生科技计划项目（2015KYB293），杭州市科技计划项目
（20131813A08、20163501Y46）及杭州市医药卫生科技计划项目（2012A020、2014A02、2015A21）联合资助。
