| 刘 萌,徐锦媚,刘 言,于 蓝,王鑫毅.甲状腺微小癌颈部淋巴结转移超声特征及淋巴结转移危险因素Logistic回归分析[J].,2018,(1):135-139 |
| 甲状腺微小癌颈部淋巴结转移超声特征及淋巴结转移危险因素Logistic回归分析 |
| Thyroid Microcarcinoma: Ultrasonography Characteristics of Neck Lymph Node Metastases and Logistic Regression Analyis of Its Risk Factors |
| 投稿时间：2017-09-01 修订日期：2017-09-28 |
| DOI：10.13241/j.cnki.pmb.2018.01.030 |
| 中文关键词: 甲状腺微小癌 颈部淋巴结转移 超声特征 危险因素 Logistic回归分析 |
| 英文关键词: Thyroid microcarcinoma Neck lymph node metastases Ultrasonography characteristics Risk factors Logistic regres- sion analysis |
| 基金项目:国家安全生产监督总局重点资助项目(000403012) |
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| 中文摘要: |
| 摘要 目的：观察甲状腺微小癌（TMC）颈部淋巴结转移的超声特征，分析TMC发生淋巴结转移的危险因素。方法：选择2013年5月~2017年6月经本院手术病理证实的TMC患者197例为研究对象，其中伴颈部淋巴结转移的60例为转移组，无颈部淋巴结转移的137例为非转移组，观察其超声图像特征，采用单因素和多因素Logistic回归分析法分析颈部淋巴结转移的独立危险因素。结果：197例TMC患者共224个病灶，术后病理证实60例（67个病灶）有颈部淋巴结转移，137例（157个病灶）无颈部淋巴结转移，以术后病理诊断结果为金标准，超声诊断TMC颈部淋巴结转移的敏感性为16.67%（10/60），特异性为94.89%（130/137），准确性为71.07%为（140/197），阳性预测值为58.82%（10/17），阴性预测值为72.22%（130/180）。单因素分析显示TMC颈部淋巴结转移与年龄、肿瘤最大径、肿瘤形态、钙化情况有关（P＜0.05）。多因素Logistic回归分析显示，年龄≤50岁、肿瘤形态不规则、微钙化是TMC颈部淋巴结转移的独立危险因素（P＜0.05）。结论：超声诊断TMC颈部淋巴结转移的敏感性低，TMC颈部淋巴结转移与年龄、肿瘤形态和钙化情况有关。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the ultrasonography characteristics of neck lymph node metastases in thyroid microcarcinoma (TMC), and analyze the risk factors of lymph node metastasis in TMC. Methods: A total of 197 TMC patients, who were proved by the operation and pathology in China Meitan General Hospital from May 2013 to June 2017, were chosen as subjects. Among them, 60 cases with neck lymph node metastasis were chosen as transfer group and 137 cases without neck lymph node metastasis, as non transfer group. The ultrasonic image characteristics of the two groups were observed. Univariate and multivariate Logistic regression analysis were used to analyze the independent risk factors of neck lymph node metastasis. Results: There were 224 lesions in 197 patients with TMC. There were 60 cases (67 lesions) with neck lymph node metastasis and 137 cases (157 lesions) without neck lymph node metastasis confirmed by the postoperative pathology. As the gold standard of the postoperative pathological diagnosis, the sensitivity of ultrasonic diagnosis with cervical lymph node metastases in TMC was 16.67% (10/60), the specificity was 94.89% (130/137), the accuracy was 71.07% (140/197), the positive predictive value was 58.82% (10/17), the negative predictive value was 72.22% (130/180). Univariate analysis showed that neck lymph node metastasis in TMC was related to patients' age, maximum diameter of tumor, tumor shape and calcification (P<0.05). Multivariate Logistic regression analysis showed that the age ≤50 years old, irregular shape and microcalcification were the in- dependent risk factors of neck lymph node metastases in TMC(P<0.05). Conclusion: The sensitivity of ultrasonic diagnosis in neck lymph node metastasis of TMC is low, and neck lymph node metastasis in TMC is related to age, morphology of tumor and calcification. |
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