李树岭, 候秀坤, 董居来, 李大鹏, 赵敬柱, 郑向前, 高明. 术前临床及原发肿瘤超声影像学特征对散发性甲状腺髓样癌侧颈淋巴结转移预测分析[J]. 中国肿瘤临床, 2019, 46(20): 1032-1035. DOI: 10.3969/j.issn.1000-8179.2019.20.655
引用本文: 李树岭, 候秀坤, 董居来, 李大鹏, 赵敬柱, 郑向前, 高明. 术前临床及原发肿瘤超声影像学特征对散发性甲状腺髓样癌侧颈淋巴结转移预测分析[J]. 中国肿瘤临床, 2019, 46(20): 1032-1035. DOI: 10.3969/j.issn.1000-8179.2019.20.655
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Li Shuling, Hou Xiukun, Dong Julai, Li Dapeng, Zhao Jingzhu, Zheng Xiangqian, Gao Ming. Prediction of lateral cervical lymph node metastasis in patients with sporadic medullary thyroid carcinoma using preoperative clinical and ultrasonographic features[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(20): 1032-1035. DOI: 10.3969/j.issn.1000-8179.2019.20.655
Citation: Li Shuling, Hou Xiukun, Dong Julai, Li Dapeng, Zhao Jingzhu, Zheng Xiangqian, Gao Ming. Prediction of lateral cervical lymph node metastasis in patients with sporadic medullary thyroid carcinoma using preoperative clinical and ultrasonographic features[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2019, 46(20): 1032-1035. DOI: 10.3969/j.issn.1000-8179.2019.20.655
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术前临床及原发肿瘤超声影像学特征对散发性甲状腺髓样癌侧颈淋巴结转移预测分析

Prediction of lateral cervical lymph node metastasis in patients with sporadic medullary thyroid carcinoma using preoperative clinical and ultrasonographic features

    摘要
  • 摘要:
      目的  探讨散发性甲状腺髓样癌（sporadic medullary thyroid carcinoma，sMTC）患者侧颈淋巴结转移的危险因素。
      方法  回顾性分析2011年2月至2017年3月期间就诊于天津医科大学肿瘤医院94例MTC患者的临床及超声特征资料，采用Fisher's精确检验及Logistic回归分析侧颈淋巴结转移的危险因素。
      结果  单因素Logistic分析显示，性别（F=5.234，P=0.022）、术前降钙素水平（F=21.327，P < 0.001）、最大径（F=5.875，P=0.015）、位置（F=6.088，P=0.014）、肿物性质（F=5.224，P=0.047）、形状（F=8.754，P=0.003）、边缘（F=15.971，P < 0.001）均与侧颈区淋巴结转移有显著性差异；多因素分析显示男性、术前降钙素>319 pg/mL、位于上极、边缘不规则、低回声是影响MTC侧颈区淋巴结转移的独立危险因素（均P < 0.05）。
      结论  男性、术前降钙素>319 pg/mL、位于上极、边缘不规则、低回声与MTC患者侧颈淋巴结转移显著相关，且随着危险因素个数的增多，发生侧颈淋巴结转移概率增加。

     

    Abstract:
      Objective  To investigate the risk factors of lateral cervical lymph node metastasis in patients with sporadic medullary thyroid carcinoma (sMTC).
      Methods  The clinical and ultrasonographic features of 94 patients with MTC treated in Tianjin Medical University Cancer Institute and Hospital from July 2009 to December 2011 were analyzed retrospectively. The risk factors for lateral cervical lymph node metastasis were analyzed using Fisher's exact test and Logistic regression.
      Results  Single factor Logistic analysis showed that male sex (F=5.234, P=0.022), preoperative calcitonin level >319 pg/mL (F=21.327, P < 0.001), maximum diameter >1.4 cm (F=5.875, P=0.015), upper pole location (F=6.088, P=0.014), pure solid type (F=5.224, P=0.047), irregular shape (F=8.754, P=0.003), and ill-defined margin (F=15.971, P < 0.001) were risk factors for lateral cervical lymph node metastasis. Multifactor analysis showed that male sex, preoperative calcitonin level >319 pg/mL, upper pole location, ill-defined margin, and hypoechoic findings on ultrasound were independent risk factors for lateral cervical lymph node metastasis.
      Conclusions  MTC patients with three or more risk factors (male sex, preoperative calcitonin level >319 pg/mL, upper pole location, irregular edge, and hypoechoic findings on ultrasound) have a higher likelihood of developing lateral cervical lymph node metastasis, and thus, preventive side neck lymph node dissection should be considered.

     

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