摘要
目的 探讨CT成像对桥本甲状腺炎(HT)合并甲状腺乳头状癌(PTC)颈部淋巴结转移(LNM)的预测价值。方法 回顾性分析孝感市中心医院2018年1月至2023年3月初次就诊行手术治疗且术后病理证实为HT合并PTC的82例患者,根据颈部是否有LNM分为有LNM组与无LNM组,分析两组性别、年龄、肿瘤个数、肿瘤最大径、平扫期HT区CT值、动脉期HT区CT值、静脉期HT区CT值以及不同期相HT区CT值的差值,采用二元Logistic回归分析LNM的独立危险因素,采用受试者操作特征(ROC)曲线评估诊断效能。结果 82例患者中,37例有LNM,45例无LNM。有LNM组与无LNM组单因素分析结果显示:年龄、肿瘤最大径、平扫CT值差异有统计学意义(P<0.05)。二元Logistic回归分析结果显示:肿瘤最大径、平扫CT值是颈部LNM的独立危险因素(P<0.05)。肿瘤最大径ROC的AUC最大为0.791,敏感度为83.8%、特异度为32.8%,此时诊断阈值为0.85 cm。平扫期HT区CT值ROC的AUC最大为0.699,敏感度为94.6%、特异度为60.0%,此时诊断阈值为72.16 HU。肿瘤最大径联合平扫期HT区CT值的ROC的AUC最大为0.835,敏感度为81.1%、特异度为80.0%。结论 肿瘤最大径、平扫期HT区CT值是HT合并PTC患者颈部LNM的独立危险因素,肿瘤最大径联合平扫期HT区CT值对HT合并PTC患者颈部LNM具有较好的预测价值。
【Objective】 To investigate the value of CT imaging for predicting cervical lymph node metastases in Hashimoto thyroiditis(HT) complicated with papillary thyroid cancer(PTC).【Methods】 A retrospective analysis was performed on 82 patients with Hashimoto thyroiditis complicated with papillary thyroid cancer confirmed by pathology after initial surgical treatment in The Central Hospital of Xiaogan from January 2018 to March 2023.They were divided into the lymph node metastasis(LNM)group and the non-LNM group according to whether there was LNM in the neck.Gender,age,number of tumors,maximum tumor diameter,HT CT value in normal scan,HT CT value in arterial phase,HT CT value in venous phase and the difference in HT CT value in different phases were analyzed by binary logistic regression and receiver operating characteristic(ROC) curv to evaluate diagnostic efficiency.【Results】 Of 82 patients,37 had LNM and 45 had no LNM.The results of univariate analysis between the LNM group and the non-LNM group showed that there were statistically significant differences in age,maximum tumor diameter and plain scan CT value(P<0.05).Binary logistic regression analysis showed that maximum tumor diameter and plain CT value were independent risk factors for neck LNM(P<0.05).The maximum area under the ROC curve(AUC) of the maximum tumor diameter was 0.791,the sensitivity was 83.8%,and the specificity was 32.8%,and the diagnostic threshold was 0.85.The maximum AUC of HT CT value in the normal scan period was 0.699,the sensitivity was 94.6%,and the specificity was 60.0%.At this time,the diagnostic threshold was 72.16.The maximum AUC of maximum tumor diameter combined with CT value of HT region in plain scan period was 0.835,the sensitivity was 81.1% and the specificity was 80.0%.【Conclusion】 Maximum tumor diameter and HT area CT value during normal scan are independent risk factors for neck LNM in patients with HT complicated with PTC.The combination of maximum tumor diameter and HT area CT value during normal scan has a good predictive value for neck LNM in patients with HT complicated with PTC.
作者
卢梦雅
张博
曾琪
方飞
李洪涛
黄帅
刘义康
吉六舟
LU Mengya;ZHANG Bo;ZENG Qi;FANG Fei;LI Hongtao;HUANG Shuai;LIU Yikang;JI Liuzhou(Jinzhou Medical University,Jinzhou,Liaoning 121000,China;Wuhan University of Science and Technology,Wuhan,Hubei 430081,China;Xiaogan Hospital Affiliated to Wuhan University of Science and Technology(The Central Hospital of Xiaogan),Xiaogan,Hubei 432000,China)
出处
《中国医学工程》
2025年第2期64-68,共5页
China Medical Engineering
