常规超声征象和血清学指标对甲状腺乳头状癌颈淋巴结转移的预测价值

IF 0.1 4区 医学
Sha Liu, MengMeng Chou
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引用次数: 0

摘要

本研究旨在评估常规超声征象和血清学指标在检测甲状腺乳头状癌(PTC)颈部淋巴结转移中的预测价值。本研究共招募了80名计划于2019年8月至2022年12月期间在我院接受手术治疗的PTC患者。有颈部淋巴结转移的患者为实验组,无颈部淋巴结转移的患者为对照组。对患者的超声体征进行分析,并测定血清学指标。采用逻辑分析法确定甲状腺乳头状癌术后发生颈淋巴结转移的危险因素,并采用接收者操作特征曲线(ROC)评估其诊断效率。两组患者的病灶数量、结节大小、钙化程度、血流RI和PI值比较有显著差异(P<0.05),而其他超声征象无显著差异(P>0.05)。有颈部淋巴结转移的患者血清中促甲状腺激素(TSH)和抗甲状腺球蛋白抗体(TG-Ab)的浓度明显高于无转移者(P < 0.05)。结节大小、病灶数量和血清促甲状腺激素水平是甲状腺乳头状癌患者颈部淋巴结转移的独立危险因素(P <0.05)。在预测甲状腺乳头状癌患者颈部淋巴结转移方面,常规超声体征结合血清学指标的诊断效率最高。这些结果显示灵敏度为0.868,特异性为0.894,ROC曲线下面积(AUC)为0.918。此外,乔登指数的计算结果为 0.761。分析表明,结节大小、病灶数量和血清促甲状腺激素浓度是甲状腺乳头状癌患者颈部淋巴结转移的独立危险因素。与使用单一诊断方法相比,将常规超声波征象和血清学指数结合使用可提供更高的诊断价值,因此具有良好的临床效益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Predictive Value of Conventional Ultrasound Signs Plus Serological Indices for Neck Lymph Node Metastasis in Papillary Thyroid Cancer
The present study aimed to evaluate the predictive value of conventional ultrasound signs and serological indices in the detection of neck lymph node metastasis in papillary thyroid cancer (PTC). A total of 80 patients with PTC scheduled for surgery in our hospital between August 2019 and December 2022 were recruited. Patients with neck lymph node metastasis were categorized as the experimental group, and patients without neck lymph node metastasis were included in the control group. Patients’ ultrasound signs were analyzed, and serological indices were determined. Logistic analysis was performed to determine the risk factors for the development of postoperative neck lymph node metastasis in papillary thyroid cancer, and the receiver operating characteristic (ROC) curve was employed to assess their diagnostic efficiency. Significant differences were observed in the number of lesions, nodule size, calcification, blood flow RI, and PI values comparison between the two arms (P < 0.05), while no significant differences were found in other ultrasound signs (P > 0.05). Patients with neck lymph node metastasis exhibited significantly higher serum concentrations of thyroid stimulating hormone (TSH) and anti-thyroglobulin antibodies (TG-Ab) versus those without metastasis (P < 0.05). Nodule size, number of lesions, and serum TSH level were independent risk factors for metastasis in neck lymph nodes in patients with papillary thyroid cancer (P <0.05). Conventional ultrasound signs, combined with serologic indices, demonstrated the highest diagnostic efficiency for predicting neck lymph node metastasis in patients with papillary thyroid cancer. These findings showed a sensitivity of 0.868, specificity of 0.894, and an area under the ROC curve (AUC) of 0.918. Additionally, the Jorden index was calculated to be 0.761. Analysis revealed that nodule size, number of lesions, and serum TSH concentration were independent risk factors for neck lymph node metastasis in papillary thyroid cancer patients. The combination of conventional ultrasound signs and serologic indices provided a higher diagnostic value compared to using a single diagnostic modality, thus indicating promising clinical benefits.
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