目的 探究超声弹性成像对甲状腺乳头状癌(PTC)的诊断价值及与临床病理特征的相关性。方法 回顾性分析武警特色医学中心2020-06至2025-06收治的120例PTC患者(研究组)及同期120例良性甲状腺结节患者(对照组)的临床资料,获取所有研究对象的超声弹性成像检查应变率比值(SR)、超声弹性成像评分(ES),利用受试者损伤特征(ROC)曲线分析SR、ES对PTC的诊断价值,并分析SR、ES与PTC患者临床病理特征的相关性。结果 研究组与对照组超声弹性成像SR、ES、微血管密度(MVD)比较,差异有统计学意义(P＜0.05)。ROC曲线结果显示,超声弹性成像参数SR、ES及二者联合诊断PTC的AUC分别为0.844(95%CI:0.777～0.911)、0.841(95%CI:0.761～0.921)及0.903(95%CI:0.844～0.961)。不同TNM分期、包膜侵犯、病灶数量、分化程度、腺外侵袭、颈侧区淋巴结转移、中央区淋巴结转移的PTC患者SR、ES比较,差异有统计学意义(P＜0.05)。结论 超声弹性成像对PTC具有较高的诊断价值,超声弹性成像SR、ES参数与PTC患者临床病理特征密切相关,通过相关参数分析有助于判断PTC侵袭程度。
Abstract
Objective To explore the value of ultrasound elastography in the diagnosis of papillary thyroid carcinoma (PTC) and its correlation with clinical pathological features. Methods A retrospective analysis was conducted on the clinical data of 120 patients with PTC and 120 patients with benign thyroid nodules admitted to Characteristics Medical Center of Chinese People's Armed Police Force between June 2020 and June 2025. The strain ratio (SR) and ultrasound elastography score (ES) of all study subjects were recorded. Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic value of SR and ES for PTC, and the correlation between SR, ES and the clinical and pathological features of PTC patients was analyzed. Results The differences in SR, ES and microvascular density (MVD) between the study group and the control group were statistically significant (P＜0.05). The ROC curve results showed that the AUC values for the diagnostic accuracy of PTC using ultrasound elasticity imaging parameters SR, ES, and their combined use were 0.844 (95%CI:0.777~0.911), 0.841 (95%CI:0.761~0.921), and 0.903 (95%CI:0.844~0.961), respectively. There were statistically significant differences in SR and ES among PTC patients with different TNM stages, capsular invasion, number of lesions, differentiation grade, extra-glandular invasion, lateral neck lymph node metastasis, and central zone lymph node metastasis (P＜0.05). Conclusions Ultrasound elastography has high diagnostic value for PTC. The SR and ES parameters of ultrasound elastography are closely related to the clinical pathological features of PTC patients. Analysis of related parameters can help determine the severity of PTC invasion.
关键词
甲状腺乳头状癌 /
超声弹性成像 /
应变率比值 /
超声弹性成像评分 /
病理特征
Key words
papillary thyroid carcinoma /
ultrasound elastography /
strain rate ratio /
ultrasound elastography score /
pathological features
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参考文献
[1] Kuenstner W,Alzedaneen Y,Burman K D.Update in papillary thyroid cancer[J].Endocrinol Metab Clin North Am,2025,54(3):329-340.
[2] 缪 娟,陈泽华.超声弹性成像与三阴性乳腺癌患者新辅助化疗效果及预后的相关性分析[J].中国超声医学杂志,2024,40(4):405-409.
[3] 吕 涛.实时超声弹性成像在子宫内膜癌浸润子宫肌层中的诊断价值——评《中国常见妇科恶性肿瘤诊治指南》[J].中国实验方剂学杂志,2023,29(14):238.
[4] 李 琦,蔡晓峰,姚 俊,等.常规超声、超声造影及超声弹性成像参数与甲状腺乳头状癌Galectin-3、SQSTM1表达水平及预后的相关性[J].放射学实践,2025,40(1):100-106.
[5] 陈 震,王成昊,赵 强,等.超声弹性成像联合US-FNAB诊断TI-RADS 4类甲状腺结节的价值探讨 [J].中国医学计算机成像杂志,2024,30(3):372-375.
[6] 高 明,葛明华,嵇庆海,等.甲状腺微小乳头状癌诊断与治疗中国专家共识(2016版)[J].中国肿瘤临床,2016,43(10):405-411.
[7] Liu Y,Yang S,Tan M,et al.Impact of thyroid nodule location on the risk of papillary thyroid carcinoma[J]. Postgrad Med J,2025,4(1):119-123.
[8] Perivoliotis K,Samara A A,Koutoukoglou P,et al.Microvessel density in differentiated thyroid carcinoma:a systematic review and meta-analysis[J].World J Methodol,2022,12(5):448-458.
[9] 贺春娇,许阳阳,李红霞.超声对甲状腺乳头状癌的诊断价值及与微血管密度、肿瘤侵袭性的相关性分析 [J].实用癌症杂志,2023,38(6):937-940.
[10] Vaghaiwalla T M,Henriksen E M,Chang J,et al.Reassessing false-negative rate and size cutoff for papillary thyroid cancer with fine-needle aspiration in thyroid nodules[J].Surgery,2025,186(1):109577.
[11] 陈卓珉,陈雨欣,郑笑娟.超声技术在非典型亚急性甲状腺炎与甲状腺乳头状癌鉴别诊断中的研究进展 [J].实用肿瘤杂志,2025,40(2):187-192.
[12] 陈雨桐,王 燕.超声诊断甲状腺乳头状癌颈部转移淋巴结的研究进展[J].肿瘤影像学,2022,31(2):203-207.
[13] Zhao J,Li L M,Gao L,et al.Prediction model construction of cervical central lymph node metastasis in papillary thyroid carcinoma combined with Hashimoto's thyroiditis utilizing conventional ultrasound and elastography[J].Gland Surg,2024,13(12):2325-2334.
[14] 乔向彬,韩 旭,师 旭,等.多模态超声对甲状腺乳头状癌腺外侵犯及颈部中央区淋巴结转移的预测价值 [J].新疆医科大学学报,2024,47(9):1264-1269.
[15] 李 猛,刘津灵,陈 新,等.超声弹性成像联合常规超声诊断甲状腺微小乳头状癌的临床价值[J].中国超声医学杂志,2024,40(12):1326-1329.
[16] 周长江,赵 浩,张胜强,等.甲状腺乳头状癌患者超声弹性成像参数与临床病理特征及预后的关系[J].山东医药,2024,64(7):28-32.
[17] 吴达熙,黄禾菁,周群群,等.超声弹性成像联合血清TSH、TK1、LMTK3对甲状腺乳头状癌的诊断价值及与肿瘤侵袭和增殖的关系研究[J].现代生物医学进展,2023,23(14):2655-2659.
[18] 郑 辉,陈文丽,蔡 昆, 等.甲状腺乳头状癌超声弹性成像特征及其与实验室检测指标的相关性[J].临床超声医学杂志,2021,23(9):708-710.
[19] 徐鑫利,李彦婷,姜 珏,等.常规超声、弹性成像联合超声造影对桥本氏甲状腺炎背景下乳头状癌的诊断价值 [J].临床超声医学杂志,2022,24(3):219-222.
[20] 何 嘉,董 赟,王 萍.超声弹性成像在甲状腺乳头状癌颈部侧方含钙化灶淋巴结转移中的诊断价值 [J].实用医学影像杂志,2023,24(1):20-22.
[21] 马 蓉,邵春晖,罗永科,等.多模态超声定量参数在预测甲状腺乳头状癌颈部淋巴结转移风险中的价值[J].分子影像学杂志,2025,48(4):502-508.
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