| CT预测甲状腺微小乳头状癌中央区淋巴结转移价值 |
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| 引用本文： | 田江雨,谭志巍.CT预测甲状腺微小乳头状癌中央区淋巴结转移价值[J].CT理论与应用研究,2023,32(1):90-96. |
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| 作者姓名： | 田江雨 谭志巍 |
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| 作者单位： | 1.成都市第三人民医院放射科, 成都610000 |
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| 基金项目： | 成都医学院校基金（CYZ18-14）。 |
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| 摘 要： | 目的：明确CT在预测甲状腺微小乳头状癌（PTMC）中央区淋巴结转移（CLNM）中的价值。方法：选取成都市第三人民医院157例经病理证实的PTMC患者，回顾分析患者的CT及临床病理资料，受试者工作特征曲线（ROC曲线）得出PTMC长径预测CLNM的最佳截断值，通过CT及临床病理资料建立PTMC CLNM的二元logistic回归模型，并通过ROC曲线评价模型的诊断价值。结果：ROC曲线得出预测PTMC CLNM的最佳截断值为6 mm；单因素分析：咬饼征、微钙化、多灶癌、PTMC长径≥6 mm、男性、年龄<45岁是PTMC CLNM的危险因素；二元Logistic回归分析：咬饼征伴突出（OR=5.159, 95%CI=1.137～23.400）、多灶癌（OR=2.734,95%CI=1.215～6.154）、PTMC长径≥6 mm(OR=3.259,95%CI=1.326～8.008)、男性（OR=3.776,95%CI=1.339～10.653）、年龄<45岁（OR=3.222,95%CI=1.419～7.777）是PTMC CLNM的独立危险因素；ROC曲线得出，约登指数=...
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| 关 键 词： | 计算机体层成像 甲状腺微小乳头状癌 Logistic回归分析 |
| 收稿时间： | 2021-09-04 |
Evaluation of CT in Predicting Central Lymph Node Metastasis of Papillary Thyroid Microcarcinoma |
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| Affiliation: | 1.Department of Radiology, the Third People's Hospital of Chengdu, Chengdu 610000, China2.Department of Pathology, China National Nuclear Corporation 416 Hospital, Chengdu 610000, China |
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| Abstract: | Objective: To determine the value of CT in predicting CLNM in PTMC. Methods: 157 patients with PTMC confirmed by pathology in our hospital were enrolled, and the CT and clinicopathological data of the patients were retrospectively analyzed. ROC curve was used to determine the optimal cutoff value of PTMC greatest diameter for CLNM. The binary logistic regression model of PTMC CLNM was established based on CT and clinical pathological data, and the diagnostic value of the model was evaluated by ROC curve. Results: According to the ROC curve, the optimal cutoff value for predicting PTMC CLNM was 6 mm. Univariate analysis: Cookie bite sign , microcalcification, multifocality, PTMC greastest diameter ≥6 mm, male, Age<45 were risk factors for PTMC CLNM. Binary Logistic regression analysis: Cookie bite sign with protruding (OR=5.159, 95% CI=1.137 ~ 23.400), multifocality (OR=2.734, 95% CI=1.215 ~ 6.154), PTMC greastest diameter ≥6 mm (OR=3.259, 95% CI=1.326 ~ 8.008), male (OR=3.776, 95% CI=1.339 ~ 10.653), age <45 (OR=3.222, 95% CI=1.419 ~ 7.777), were independent risk factors for PTMC CLNM. According to the ROC curve, when the Youden index=0.502, the sensitivity and specificity in predicting CLNM were 82.5% and 68.0%, respectively. Conclusion: The binary logistic regression model is helpful in predicting PTMC CLNM. Cookie bite sign with protruding, PTMC greastest diameter≥6 mm, male, and age<45 were independent risk factors for PTMC CLNM. For this type of patients, we suggest that surgeons should consider central lymph node dissection. |
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