甲状腺癌的超声检查特征与颈部淋巴结转移的关系

摘要

Objective To investigate the correlation between ultrasonographic characteristics of thyroid carcinoma and cervical lymph node metastasis. Methods One hundred and fifty-one patients with thyroid carcinoma who were admitted and treated in our hospital from February 2014 to March 2016 were enrolled in the study. According to whether they had cervical lymph node metastasis or not,these patients were divided into observation group with cervical lymph node metastasis (n = 81) and control group without cervical lymph node metastasis (n = 70),then the correlation between ultrasound examination findings of thyroid carcinoma and cervical lymph node metastasis was analyzed. Results The sensitivity of ultrasound in diagnosis of cervical lymph node metastasis was 71. 84%,the specificity was 86. 32%,the positive predictive value was 85. 06% and negative predictive value was 73. 87% . In the ultrasound characteristics of thyroid cancer,the length and breadth ratio≥1,with unclear boundary,heterogeneous echotexture,rich blood supply,and microcalcification rates were 29. 63%, 34. 57%,70. 37%,76. 54%,60. 49%,respectively,which were significantly higher than those in control group (P < 0. 05). The peak systolic velocity (PSV)and resistance index (RI)in observation group were (35. 40 ± 7. 81)cm/ s and (0. 72 ± 0. 09),respectively,which were significantly higher than those in control group (P < 0. 05). Logistic regression analysis showed microcalcification,rich blood supply,the length and breadth ratio≥1 and uneven echo were risk factors of cervical lymph node metastasis (OR = 3. 877,5. 212,2. 762,3. 056,respectively,P < 0. 05). Conclusion The partial ultrasound findings of thyroid carcinoma have a certain value in predicting cervical lymph node metastasis,therefor,which can provide reference for clinical diagnosis and treatment.%目的 探讨甲状腺癌的超声检查特征与颈部淋巴结转移的关系.方法 甲状腺癌患者151例,其中81例患者发生颈部淋巴结转移(观察组),70例患者无颈部淋巴结转移(对照组),分析甲状腺癌超声表现与颈部淋巴结转移的关系.结果 超声判断颈部淋巴结转移的灵敏度为71.84%、特异度为86.32%、阳性预测值为85.06%、阴性预测值为73.87%;甲状腺癌超声表现中,纵横比≥1、边界不清、内部回声不均匀、内部血供丰富和微小钙化的比例分别为29.63%、34.57%、70.37%、76.54%和60.49%,明显高于对照组(P<0.05);观察组收缩期最高流速(PSV)和阻力指数(RI),明显高于对照组(P<0.05);Logistic回归分析,结果显示微小钙化、血供丰富、纵横比≥1和回声不均匀是颈部淋巴结转移的危险因素(OR=3.877、5.212、2.762和3.056,P<0.05).结论 甲状腺癌部分超声表现在预测颈部淋巴结转移方面有一定的价值,可为临床诊治提供参考.