目的:回顾性研究甲状腺微小乳头状癌(papillary thyroid microcarcinoma, PTMC)发生中央区淋巴结转移(Central lymph node metastasis, CLNM)的影响因素。方法:收集2019年12月至2022年12月期间就诊于乌鲁木齐市中医院并经病理诊断为PTM...目的:回顾性研究甲状腺微小乳头状癌(papillary thyroid microcarcinoma, PTMC)发生中央区淋巴结转移(Central lymph node metastasis, CLNM)的影响因素。方法:收集2019年12月至2022年12月期间就诊于乌鲁木齐市中医院并经病理诊断为PTMC的患者103例,分析其性别、年龄、民族、体重指数、TSH值、肿瘤直径、被膜侵犯、微钙化灶、癌灶数量、有无合并症与CLNM的相关性。结果:PTMC发生CLNM率为39.87% (41/103),经单因素分析,性别、年龄、肿瘤直径、微钙化灶及癌灶数量是PTMC发生CLNM的危险因素(P P Objective: To retrospectively study the influencing factors of central lymph node metastasis (CLNM) in papillary thyroid microcarcinoma (PTMC). Methods: 103 patients who attended Urumqi Hospital of Traditional Chinese Medicine and were diagnosed as PTMC by pathology between December 2019 and December 2022 were collected, and the correlation between gender, age, ethnicity, body mass index, TSH value, tumor diameter, peritumoral invasion, microcalcified foci, the number of cancer foci, the presence of comorbidities and CLNM was analyzed. Results: The incidence of CLNM in PTMC was 39.87% (41/103), and by univariate analysis, gender, age, tumor diameter, microcalcified foci, and the number of cancer foci were the risk factors for the occurrence of CLNM in PTMC (P P < 0.05). Conclusion: Gender, age, ethnicity, body mass index, TSH value, tumor diameter, peritumoral invasion, microcalcified foci, number of cancer foci, and comorbidities can be used as predictive factors for quantitative risk assessment of the occurrence of CLNM in PTMC, which can provide a reference for further selection of suitable treatment options.展开更多
目的:建立列线图预测模型于术前预测甲状腺乳头状癌(papillary carcinoma of the thyroid,PTC)患者出现颈部中央区淋巴结转移(central lymph node metastasis,CLNM)的风险,减少术后并发症的发生概率,达到精准治疗的目的。方法:选择364例...目的:建立列线图预测模型于术前预测甲状腺乳头状癌(papillary carcinoma of the thyroid,PTC)患者出现颈部中央区淋巴结转移(central lymph node metastasis,CLNM)的风险,减少术后并发症的发生概率,达到精准治疗的目的。方法:选择364例PTC患者为研究对象,根据术后中央淋巴结病理学检查结果进行分组。收集患者的一般临床资料及超声资料,利用最小绝对收缩与选择算子(least absolute shrinkage and selection operator,LASSO)回归进行因素选择,多因素logistic回归筛选CLNM的独立影响因素,建立列线图模型以预测CLNM的风险,并通过内部验证评价列线图的应用价值。结果:多因素logistic回归分析示年龄<45岁、结节前后径超过1 cm、结节形态不规则、病灶多发、超声发现可疑淋巴结是PTC患者出现CLNM的独立影响因素(P<0.05)。根据多因素回归结果构建列线图预测模型,其在内部验证中表现出良好的区分度及校准度。列线图模型准确度(0.730,95%CI 0.681~0.775)较单一颈部淋巴结超声(0.638,95%CI 0.586~0.688)显著提高(P<0.001)。结论:基于临床及超声特征建立的列线图能实现PTC患者CLNM的术前预测,有望为临床制订治疗方案提供指导意见。展开更多
目的:以单中心资料为研究对象,建立包含超声声像图特征的甲状腺乳头状癌(papillary carcinoma of the thyroid,PTC)患者中央区淋巴结转移(central lymph node metastasis,CLNM)预测模型,以辅助临床进行术前评估、针对患者选择个体化的...目的:以单中心资料为研究对象,建立包含超声声像图特征的甲状腺乳头状癌(papillary carcinoma of the thyroid,PTC)患者中央区淋巴结转移(central lymph node metastasis,CLNM)预测模型,以辅助临床进行术前评估、针对患者选择个体化的治疗方案。方法:研究共纳入912例经术后病理学检查证实的PTC患者,收集一般情况、实验室指标和超声声像图,将其随机分为训练组(n=727)和验证组(n=185)。在训练组中研究CLNM的相关因素,采用logistic回归分析法建立预测模型,绘制列线图预测CLNM的风险,在验证组中对其效能进行验证,并利用临床决策曲线对其临床应用进行评价。结果:本研究建立了包含性别、年龄、病灶总直径(total tumor diameter,TTD)、促甲状腺激素(thyroid stimulating hormone,TSH)、钙化、病灶与甲状腺包膜的关系和桥本甲状腺炎的预测模型,在验证组和训练组中得到的曲线下面积(area under curve,AUC)分别为0.746和0.826。与术前超声相比,预测模型提高了诊断的灵敏度,并且通过临床决策曲线体现了其临床收益。结论:利用logistic回归建立的列线图预测模型,在预测PTC患者CLNM中体现出了较好的效能,能够补充超声诊断的不足。展开更多
文摘目的:回顾性研究甲状腺微小乳头状癌(papillary thyroid microcarcinoma, PTMC)发生中央区淋巴结转移(Central lymph node metastasis, CLNM)的影响因素。方法:收集2019年12月至2022年12月期间就诊于乌鲁木齐市中医院并经病理诊断为PTMC的患者103例,分析其性别、年龄、民族、体重指数、TSH值、肿瘤直径、被膜侵犯、微钙化灶、癌灶数量、有无合并症与CLNM的相关性。结果:PTMC发生CLNM率为39.87% (41/103),经单因素分析,性别、年龄、肿瘤直径、微钙化灶及癌灶数量是PTMC发生CLNM的危险因素(P P Objective: To retrospectively study the influencing factors of central lymph node metastasis (CLNM) in papillary thyroid microcarcinoma (PTMC). Methods: 103 patients who attended Urumqi Hospital of Traditional Chinese Medicine and were diagnosed as PTMC by pathology between December 2019 and December 2022 were collected, and the correlation between gender, age, ethnicity, body mass index, TSH value, tumor diameter, peritumoral invasion, microcalcified foci, the number of cancer foci, the presence of comorbidities and CLNM was analyzed. Results: The incidence of CLNM in PTMC was 39.87% (41/103), and by univariate analysis, gender, age, tumor diameter, microcalcified foci, and the number of cancer foci were the risk factors for the occurrence of CLNM in PTMC (P P < 0.05). Conclusion: Gender, age, ethnicity, body mass index, TSH value, tumor diameter, peritumoral invasion, microcalcified foci, number of cancer foci, and comorbidities can be used as predictive factors for quantitative risk assessment of the occurrence of CLNM in PTMC, which can provide a reference for further selection of suitable treatment options.
文摘目的:以单中心资料为研究对象,建立包含超声声像图特征的甲状腺乳头状癌(papillary carcinoma of the thyroid,PTC)患者中央区淋巴结转移(central lymph node metastasis,CLNM)预测模型,以辅助临床进行术前评估、针对患者选择个体化的治疗方案。方法:研究共纳入912例经术后病理学检查证实的PTC患者,收集一般情况、实验室指标和超声声像图,将其随机分为训练组(n=727)和验证组(n=185)。在训练组中研究CLNM的相关因素,采用logistic回归分析法建立预测模型,绘制列线图预测CLNM的风险,在验证组中对其效能进行验证,并利用临床决策曲线对其临床应用进行评价。结果:本研究建立了包含性别、年龄、病灶总直径(total tumor diameter,TTD)、促甲状腺激素(thyroid stimulating hormone,TSH)、钙化、病灶与甲状腺包膜的关系和桥本甲状腺炎的预测模型,在验证组和训练组中得到的曲线下面积(area under curve,AUC)分别为0.746和0.826。与术前超声相比,预测模型提高了诊断的灵敏度,并且通过临床决策曲线体现了其临床收益。结论:利用logistic回归建立的列线图预测模型,在预测PTC患者CLNM中体现出了较好的效能,能够补充超声诊断的不足。
