基于临床、血清学及CT特征列线图预测甲状腺乳头状癌中央区淋巴结转移的价值

doi:10.12117/jccmi.2020.06.004

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Abstract Objective: To analyze the clinical, serological and CT features of papillary carcinoma(PTC) and search independent risk factors associated with lymph node metastasis in the central region of neck. Methods: One hundred and twenty-six cases in our hospital confirmed for PTC by immunohistochemistry after thyroid surgery from January 2017 to May 2019 were divided into central lymph node metastasis(CLNM) positive group and CLNM negative group according to the presence of lymph node metastasis in central region. Then clinical, serological and CT imaging features of the two groups were analyzed by single factor and Logistic stepwise regression to determine independent risk factors responsible for cervical lymph node metastasis in the central region of neck. The results of the prediction model were visualized by using nomograms, and the prediction model was evaluated by using ROC curve. Results: The result showed that age, tumor maximum diameter, tumor site, venous CT value, multiple lesions, microcalcification, capsule invasion, thyroglobulin(Tg) and thyroid stimulating hormone(TSH) were significantly correlated with CLNM(P<0.05) according to single factor analysis of 65 cases of CLNM positive group and 61 cases of CLNM negative group. The model optimization ultimately included age, cancer site, venous CT value, multiple lesions, microcalcification, and envelope invasion into the prediction model. The nomogram was established based on independent risk factors selected by Logistic stepwise regression, with AUC of 0.806, specificity of 0.705 and sensitivity of 0.769. Conclusion: The younger the age of the patients, the middle stage, low CT value(venous stage) enhancement, multiple lesions, microcalcification and capsule invasion are independent risk factors for lymph node metastasis in the central region of PTC.

Key words： Thyroid neoplasms Carcinoma, papillary Tomography, spiral computed

Received: 18 November 2019

PACS:	Ｒ736.1
	Ｒ730.261
	Ｒ445.2

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	Articles by authors
	LIU Wen-hua
	SHI Yang
	LI Min
	GENG Xing-dong
	REN Guo-qiang
	ZHANG Heng
	TANG Zhi-yang
	JIANG Min

Cite this article:

LIU Wen-hua,SHI Yang,LI Min, et al. The value of clinical, serological and CT characteristic nomogram in predicting lymph node metastasis in the central region of thyroid papillary carcinoma[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(6): 394-397.

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http://www.jccmi.com.cn/EN/10.12117/jccmi.2020.06.004 OR http://www.jccmi.com.cn/EN/Y2020/V31/I6/394

[1]Lim H, Devesa SS, Sosa JA, et al. Trends in thyroid cancer incidence and mortality in the united states, 1974-2013[J]. JAMA, 2017, 317(13): 1338-1348.
[2]Ahn BH, Kim JR, Jeong HC, et al. Predictive factors of central lymph node metastasis in papillary thyroid carcinoma[J]. Ann Surg Treat Res, 2015, 88(2): 63-68.
[3]Conzo G, Docimo G, Pasquali D, et al. Predictive value of nodal metastases on local recurrence in the management of differentiated thyroid cancer. Retrospective clinical study[J]. BMC Surg, 2013, 13(suppl 2): S3.
[4]Tao Y, Wang C, Li L, et al. Clinicopathological features for predicting central and lateral lymphnode metastasis in papillary thyroid microcarcinoma: Analysis of 66 cases that underwent central and lateral lymph node dissection[J]. Mol Clin Oncol, 2017, 6(1): 49-55.
[5]Yang Y, Chen C, Chen Z, et al. Prediction of central compartment lymphnode metastasis in papillary thyroid microcarcinoma[J]. Clin Endocrinol(Oxf), 2014, 81(2): 282-288.
[6]王晓庆，魏玮，魏玺，等. 甲状腺乳头状癌的超声表现及其与颈部中央区淋巴结转移的关系[J]. 中华肿瘤杂志，2018，40（3）：196-200.
[7]孙庆贺，张磊，杨进宝，等. 2073例乳头状甲状腺癌淋巴结转移的因素分析[J]. 中华外科杂志，2017，55（8）：592-598.
[8]Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer[J]. Thyroid, 2016, 26(1): 1-133.
[9]中华医学会放射学分会头颈学组. 甲状腺结节影像检查流程专家共识[J]. 中华放射学杂志，2016，50（12）：911-915.
[10]郑克思，曾勇，陈聪，等. 基于监测、流行病学和最终结果数据库甲状腺乳头状微癌颈部淋巴结转移的危险因素[J]. 中国医学科学院学报，2018，40（6）：736-743.
[11]李顺波，黄晶晶，郭丹. 甲状腺乳头状癌颈部中央区淋巴结转移的危险因素分析[J]. 暨南大学学报：自然科学与医学版，2018，39（6）：524-528.
[12]杨海，舒艳艳，韩志江，等. 直径＞1.0cm的甲状腺乳头状癌多种CT征象的多因素分析[J]. 中华内分泌外科杂志，2018，12（1）：51-54.
[13]王海滨，舒艳艳，韩志江，等. 不同大小甲状腺乳头状癌的CT征象比较[J]. 中华内分泌外科杂志，2018，12（2）：132-135.
[14]王海滨，舒艳艳，韩志江，等. CT在甲状腺结节良、恶性风险评估中的价值[J]. 中华医学杂志，2017，97（35）：2766-2769.
[15]Wu CW, Dionigi G, Lee KW, et al. Calcifications in thyroid nodules identified on preoperative computed tomography: Patterns and clinical significance[J]. Surgery, 2012, 151(3): 464-470.
[16]韩志江，陈文辉，周健，等. 微小甲状腺癌的CT特点[J]. 中华放射学杂志，2012，46（2）：135-138.