目的 探讨甲状腺乳头状癌(PTC)伴桥本甲状腺炎(HT)患者中央淋巴结转移的危险因素及术前预测价值。方法 回顾性分析2020-01至2022-12武警特色医学中心收治的257例PTC伴HT患者的基本信息、术前超声特征和甲状腺功能。根据有或无中央淋巴结转移分为两组,使用多因素logistic回归分析探讨影响中央淋巴结转移的危险因素。结果 257例中有118例(45.91%)存在中央淋巴结转移。与无中央淋巴结转移患者比较,中央淋巴结转移患者的平均血清TGAb水平高,血清TPOAb水平低(P=0.00)。多因素logistic回归分析显示,肿瘤位置(中部OR=2.162,95%CI:1.892～2.470,P=0.000;下部OR= 6.763,95%CI:3.647～12.53,P=0.000)、中央淋巴结边缘不规则(OR=3.535,95%CI:1.303～9.586,P=0.013)、中央淋巴结微钙化(OR=9.916,95%CI:5.264～18.67,P=0.000)、血清TGAb水平升高(OR=7.124,95%CI:1.560～1.905,P=0.000)是PTC伴HT患者中央淋巴结转移发生的独立危险因素。结论 术前超声特征结合血清TGAb水平可以预测PTC伴HT患者的中央淋巴结转移情况。
Abstract
Objective To investigate the risk factors and preoperative prediction value of central lymph node metastasis in patients with papillary thyroid carcinoma (PTC) and Hashimoto's thyroiditis (HT).Methods A retrospective analysis was conducted on the basic information, preoperative ultrasound features, and thyroid function of 257 PTC patients with HT admitted to Characters Medical Center of Chinese People's Armed Police Force from January 2020 to December 2022. The patients were divided into two groups based on the presence or absence of central lymph node metastasis. Multivariate logistic regression analysis was used to explore the risk factors affecting central lymph node metastasis.Results Among the 257 PTC patients, 118 (45.91%) cases had central lymph node metastasis. Compared with the patients without central lymph node metastasis, patients with central lymph node metastasis had higher levels of serum TGAb (P=0.000) and lower levels of serum TPOAb (P=0.00). Multivariate logistic regression analysis showed that the tumor location (central OR=2.162,95%CI: 1.892-2.470, P=0.000, lower OR=6.763,95%CI: 3.647-12.53, P=0.000) and the central lymph node margin were irregular (OR=3.535,95% CI: 1.303-9.586, P=0.013); Microcalcification of central lymph nodes (OR=9.916,95%CI:5.264-18.67,P=0.000) and elevated serum TGAb levels (OR=7.124,95%CI:1.560-1.905, P=0.000) were independent risk factors for central lymph node metastasis in PTC with HT patients.Conclusions Preoperative ultrasound features combined with serum TGAb levels can predict central lymph node metastasis in patients with PTC and HT.
关键词
甲状腺癌 /
中央淋巴结转移 /
无创 /
危险因素
Key words
thyroid cancer /
central lymph node metastasis /
non-invasive /
risk factors
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基金
山东省自然科学基金青年项目(ZR2020QH278)
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