[1]陈琼,叶小芬,王康健,等.伴有不同甲状腺疾病的乳头状癌颈中央区淋巴结转移预测模型建立与验[J].福建医药杂志,2023,45(06):4-9.
　CHEN Qiong,YE Xiaofen,WANG Kangjian,et al.Prediction of papillary thyroid metastases to the central compartment: proposal of a model taking into consideration other thyroid conditions[J].FUJIAN MEDICAL JOURNAL,2023,45(06):4-9.
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伴有不同甲状腺疾病的乳头状癌颈中央区淋巴结转移预测模型建立与验()
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
45
期数:
2023年06期
页码:
4-9
栏目:
临床研究
出版日期:
2023-12-15

文章信息/Info

Title:
Prediction of papillary thyroid metastases to the central compartment: proposal of a model taking into consideration other thyroid conditions
文章编号:
1002-2600(2023)06-0004-06
作者:
陈琼; 叶小芬1; 王康健; 沈浩霖2
福建医科大学附属漳州市医院超声医学科(漳州 363000)
Author(s):
CHEN Qiong;  YE Xiaofen;  WANG Kangjian;  SHEN Haolin
Department of Ultrasound, Zhangzhou Hospital Affiliated to Fujian Medical University, Zhangzhou, Fujian, 363000, China
关键词:
甲状腺乳头状癌;  中央区淋巴结;  超声;  预测;  模型
Keywords:
papillary thyroid carcinoma;  central lymph node;  ultrasound;  prediction;  model
分类号:
R736.1
文献标志码:
A
摘要:
目的 分析合并不同甲状腺疾病时,甲状腺乳头状癌(PTC)发生颈中央区淋巴结转移(CLNM)的相关危险因素,比较各组间的差异,构建相应的风险预测模型并验证可行性与准确性。方法 纳入2021年2—12月接受手术治疗且术后病理确诊为PTC的患者共518例,记录患者一般情况、超声及病理资料,依据无伴发疾病、伴发桥本甲状腺炎(HT)及结节性甲状腺肿(NG)将患者进行分组,采用单因素差异性分析和多因素logistic回归,分析各组发生中央区淋巴结转移的独立危险因素,构建对应的风险预测模型并进行比较。结果 无伴发甲状腺疾病患者发生CLNM的独立危险因素为甲状腺结节最大径(OR=1.27,P<0.001)、ACR评分(OR=1.35,P=0.003); 伴发HT患者的独立危险因素为甲状腺结节最大径(OR=1.31,P<0.001)、ACR评分(OR=1.36,P=0.005)及多发病灶(OR=2.92,P=0.026); 伴发NG患者的独立危险因素为甲状腺结节最大径(OR=1.07,P=0.003)、ACR评分(OR=1.25,P<0.001)、多发病灶(OR=2.48,P<0.001)及性别(OR=2.48,P=0.004)。结论 伴发NG是PTC患者发生CLNM的独立危险因素; PTC患者伴有不同疾病时发生CLNM的独立危险因素不同。超声能够较为准确地判断PTC患者是否伴发其他甲状腺疾病,在此基础上采用相应的预测模型,可以准确地评估患者发生CLNM的风险。
Abstract:
Objective To construct risk prediction models for cervical lymph node metastasis(CLNM)of papillary thyroid carcinoma(PTC)under different thyroid disease backgrounds and to analyze and compare risk factors among different groups.Methods This retrospective study included 518 patients with PTC that was pathologically confirmed post-operatively from February 2021 to November 2021.Demographic, ultrasound and pathological data were recorded.Univariate and multivariate logistic regression analyses were performed to identify factors associated with CLNM in the whole patient cohort and in patients grouped according to diagnoses of Hashimotos thyroiditis(HT), nodular goiter(NG), and no background disease.Prediction models were constructed, and their performances were compared.Results Analysis of the whole PTC patient cohort identified NG as independently associated with CLNM.The independent risk factors for patients with no background disease were the maximum thyroid nodule diameter(OR=1.27,P<0.001)and American College of Radiology Thyroid Imaging Reporting&Data System score(OR=1.35,P=0.003); those for patients with HT were the maximum thyroid nodule diameter(OR=1.31,P<0.001), ACR TI-RADS score(OR=1.36,P=0.005), and multifocality(OR=2.48,P<0.001); and those for patients with NG were the maximum thyroid nodule diameter(OR=1.07,P=0.003), ACR TI-RADS score(OR=1.25,P<0.001), multifocality(OR=2.48,P<0.001)and gender(OR=2.48,P=0.004).Conclusion Thyroid disease impacts CLNM in PTC patients, and risk factors for CLNM vary among PTC patients with different background diseases.Ultrasound is useful for diagnosing background thyroid disease, which can inform treatment planning.Different prediction models are recommended for PTC cases.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目:福建省自然科学基金项目(2022J011478)
1 福建医科大学临床医学部; 2 通信作者, Email: holin3344@163.com
更新日期/Last Update: 2023-12-15