甲状腺乳头状癌的超声及临床特征与跳跃性转移的相关性分析

摘要

Objective To explore the sonographic features and clinical factors associated with skip metastasis in papillary thyroid carcinoma (PTC).Methods We reviewed 276 PTC cases pathologically confirmed after operation in our hospital,analyzing the ultrasonographic features and clinical characteristics of primary site and risk factors of skip metastasis.Results The rate of skip metastasis was 16.6％,and level Ⅱ or level Ⅲ were the most common area.In univariate analysis,skip metastasis was associated with tumor location,tumor maximum size,and calcification.Multivariate analysis showed the primary tumor location in the upper portion,tumor size ≤ 10 mm,and microcalcification were independent predictive factors for skip metastasis.Conclusions In papillary thyroid carcinoma,skip metastases rate is high when primary tumor location in the upper portion,tumor size ≤ 10 mm,and there is microcalcification.%目的 探讨甲状腺乳头状癌的超声及临床特征与跳跃性转移的关系.方法 回顾性分析在我院手术且经病理证实的276例甲状腺乳头状癌患者的资料,分析原发灶的超声及临床特征与跳跃性转移的相关危险因素.结果 跳跃性转移的发生率为16.6％,侧颈Ⅱ、Ⅲ区为其转移最多的区域.单因素分析显示原发灶的超声及临床特征中结节位置、钙化模式及结节最大径与跳跃性转移的发生相关;多因素Logistic回归分析显示甲状腺上极结节、结节最大径≤10 mm及存在微钙化是跳跃性转移发生的独立危险因素.结论 当癌结节≤10 mm且位于腺体的上极、同时具有微钙化的超声特征时,侧颈Ⅱ区发生跳跃性转移的可能性较大.