甲状腺乳头状癌常规超声图像特征及声触诊组织成像预测颈部淋巴结转移的价值研究

doi:10.12117/jccmi.2020.01.003

摘要
图/表
参考文献(11)
相关文章 (15)

全文: PDF (0 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的：探讨甲状腺乳头状癌（Papillary thyroid carcinoma，PTC）原发灶的常规超声特征及声触诊组织成像（Virtual touch tissue imaging，VTI）对颈部淋巴结转移的预测价值。方法：根据术后病理结果将77例PTC分为淋巴结转移组和非转移组，对其术前常规超声图像及VTI分级进行分析，比较各个因素与淋巴结的转移情况有无相关性。将各独立危险因素赋值为1，计算每个结节包含危险因素的分值，绘制ROC曲线，确定最佳截点。结果：单因素及多因素分析显示，微钙化、极低回声、血流Adler分级Ⅱ~Ⅲ级及VTI 6级为颈部淋巴结转移的独立危险因素。ROC曲线表明，PTC原发灶具备≥2项独立危险因素，对颈部淋巴结转移有较好的预测价值，其敏感度为94.7%，特异度为82.1%，准确性为88.3%。结论：PTC原发灶常规超声图像特征及VTI可以预测颈部淋巴结转移情况，微钙化、极低回声、血流Adler分级Ⅱ~Ⅲ级及VTI 6级是其独立危险因素。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	王晶
	鹿皎
	王荣
	刘洁
	王玉乔
	王兴田

关键词 ：甲状腺肿瘤, 癌, 乳头状, 淋巴转移, 超声检查, 多普勒, 彩色

Abstract：Objective: To investigate the value of conventional ultrasound image features and virtual touch tissue imaging(VTI) in the estimate of cervical lymph node metastasis of papillary thyroid carcinoma(PTC). Methods: According to the postoperative pathological results, 77 patients with PTC were divided into lymph node metastasis group and non-metastasis group. The preoperative routine ultrasound images and VTI grades were analyzed to compare the correlation between each factor and lymph node metastasis. Assign each independent risk factor to 1, calculate the score for each nodule, receiver operating characteristic(ROC) curve was used to determine the cut off spot. Results: Monofactor and multivariate analysis showed the micro-calcification, very hypoechoic, flow grade of Ⅱ~Ⅲ and VTI grade 6 were independent risk factors with cervical lymph node metastasis(P<0.05). The ROC curve showed that when PTC primary tumors had ≥2 independent risk factors, it had a high predictive value for cervical lymph node metastasis, the sensitivity, specificity, accuracy of predicting cervical lymph nodes metastasis was 94.7%, 82.1%, 88.3% respectively. Conclusion: Conventional ultrasound image features and VTI can predict cervical lymph node metastasis. Micro-calcification, very hypoechoic, flow grade of Ⅱ~Ⅲ and VTI grade 6 were independent risk factors for cervical lymph node metastasis.

Key words： Thyroid neoplasms Carcinoma, papillary Lymphatic metastasis Ultrasonography, Doppler, color

收稿日期: 2019-04-04

PACS:
	Ｒ736.1
	Ｒ730.261
	Ｒ445.1

通讯作者: 王兴田，徐州医科大学附属医院超声医学科，221006。E-mail：tianxingwang999@163.com

作者简介: 王晶（1986-），女，江苏连云港人，在读硕士研究生。E-mail：573273270@qq.com

引用本文:

王晶，鹿皎，王荣，刘洁，王玉乔，王兴田. 甲状腺乳头状癌常规超声图像特征及声触诊组织成像预测颈部淋巴结转移的价值研究[J]. 中国临床医学影像杂志, 2020, 31(1): 11-14.
WANG Jing, LU Jiao, WANG Rong, LIU Jie, WANG Yu-qiao, WANG Xing-tian. The value of conventional ultrasound image features and virtual touch tissue imaging in #br# the estimate of cervical lymph node metastasis of papillary thyroid carcinoma. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(1): 11-14.

链接本文:

http://www.jccmi.com.cn/CN/10.12117/jccmi.2020.01.003 或 http://www.jccmi.com.cn/CN/Y2020/V31/I1/11

[1]张磊，杨进宝，樊宇芳，等. cN_0甲状腺乳头状癌淋巴结转移的危险因素分析[J]. 中国癌症杂志，2016，26（1）：73-79.
[2]Adler DD, Carson PL, Rubin JM, et al. Doppler ultrasound color flow imaging in the study of breast cancer: preliminary findings[J]. Ultrasound Med Biol, 1990, 16(6): 553-559.
[3]陈胜华，李泉水，邓水平，等. VTI对不同大小甲状腺结节的鉴别诊断价值[J]. 中国超声医学杂志，2014，30（2）：100-103.
[4]丁珂，严昆. 超声对预测甲状腺乳头状癌颈部淋巴结转移的研究进展[J]. 中国临床医学影像杂志，2016，27（9）：663-666.
[5]马文卿，周平，梁永平，等. 甲状腺微小乳头状癌中央区颈部淋巴结转移风险评分系统的初步构建[J]. 中国普通外科杂志，2018，27（6）：752-760.
[6]Nam SY, Shin JH, Han B, et al. Preoperative Ultrasonographic Features of Papillary Thyroid Carcinoma Predict Biological Behavior[J]. J Clin Endocrinol Metab, 2013, 98(4): 1476-1482.
[7]葛妍，马富成，冷晓玲，等. 甲状腺乳头状癌超声表现与颈部淋巴结转移的相关性[J]. 中国医学影像学杂志，2014，22（6）：418-420.
[8]孙咏梅，刘韶平，马喆，等. 骨桥蛋白在乳头状甲状腺癌中的表达及意义[J]. 中国现代普通外科进展，2009，12（1）：24-28.
[9]索晓鹏，何小玲，何向辉，等. 甲状腺乳头状癌滤泡亚型声像图及临床病理特征分析[J]. 天津医科大学学报，2015，21（2）：154-157.
[10]Xu J, Xu X, Xu H, et al. Prediction of cervical lymph node metastasis in patients with papillary thyroid cancer using combined conventional ultrasound, strain elastography, and acoustic radiation force impulse(ARFI) elastography[J]. Eur Radiol, 2016, 26(8): 2611-2622.
[11]喻玲，武心萍，丁文波，等. 甲状腺乳头状癌BRAFv600e基因突变与其弹性超声的相关性[J]. 中国超声医学杂志，2017，33（9）：772-775.