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[1]陳瓊,葉小芬,王康健,等.伴有不同甲狀腺疾病的乳頭狀癌頸中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移預(yù)測模型建立與驗[J].福建醫(yī)藥雜志,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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伴有不同甲狀腺疾病的乳頭狀癌頸中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移預(yù)測模型建立與驗()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
45
期數(shù):
2023年06期
頁碼:
4-9
欄目:
臨床研究
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
文章編號:
1002-2600(2023)06-0004-06
作者:
陳瓊; 葉小芬1; 王康健; 沈浩霖2
福建醫(yī)科大學(xué)附屬漳州市醫(yī)院超聲醫(yī)學(xué)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
關(guān)鍵詞:
甲狀腺乳頭狀癌;  中央?yún)^(qū)淋巴結(jié);  超聲;  預(yù)測;  模型
Keywords:
papillary thyroid carcinoma;  central lymph node;  ultrasound;  prediction;  model
分類號:
R736.1
文獻標志碼:
A
摘要:
目的 分析合并不同甲狀腺疾病時,甲狀腺乳頭狀癌(PTC)發(fā)生頸中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移(CLNM)的相關(guān)危險因素,比較各組間的差異,構(gòu)建相應(yīng)的風(fēng)險預(yù)測模型并驗證可行性與準確性。方法 納入2021年2—12月接受手術(shù)治療且術(shù)后病理確診為PTC的患者共518例,記錄患者一般情況、超聲及病理資料,依據(jù)無伴發(fā)疾病、伴發(fā)橋本甲狀腺炎(HT)及結(jié)節(jié)性甲狀腺腫(NG)將患者進行分組,采用單因素差異性分析和多因素logistic回歸,分析各組發(fā)生中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移的獨立危險因素,構(gòu)建對應(yīng)的風(fēng)險預(yù)測模型并進行比較。結(jié)果 無伴發(fā)甲狀腺疾病患者發(fā)生CLNM的獨立危險因素為甲狀腺結(jié)節(jié)最大徑(OR=1.27,P<0.001)、ACR評分(OR=1.35,P=0.003); 伴發(fā)HT患者的獨立危險因素為甲狀腺結(jié)節(jié)最大徑(OR=1.31,P<0.001)、ACR評分(OR=1.36,P=0.005)及多發(fā)病灶(OR=2.92,P=0.026); 伴發(fā)NG患者的獨立危險因素為甲狀腺結(jié)節(jié)最大徑(OR=1.07,P=0.003)、ACR評分(OR=1.25,P<0.001)、多發(fā)病灶(OR=2.48,P<0.001)及性別(OR=2.48,P=0.004)。結(jié)論 伴發(fā)NG是PTC患者發(fā)生CLNM的獨立危險因素; PTC患者伴有不同疾病時發(fā)生CLNM的獨立危險因素不同。超聲能夠較為準確地判斷PTC患者是否伴發(fā)其他甲狀腺疾病,在此基礎(chǔ)上采用相應(yīng)的預(yù)測模型,可以準確地評估患者發(fā)生CLNM的風(fēng)險。
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.

參考文獻/References:

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備注/Memo

備注/Memo:
基金項目:福建省自然科學(xué)基金項目(2022J011478)
1 福建醫(yī)科大學(xué)臨床醫(yī)學(xué)部; 2 通信作者, Email: [email protected]
更新日期/Last Update: 2023-12-15