Objective To explore the correlation between the ultrasonic signs of primary focus of papillary thyroid carcinoma (PTC) and cervical lymphatic metastasis. Methods Ultrasonic signs of 135 patients with PTC were analyzed before surgery. Forty-one patients with cervical lymph node metastasis were devided into metastasis group, while 94 patients without metastasis in control group. Degree of coincidence was measured with k statistics between ultrasonic signs and pathology. A Logistic regression model was established by cervical lymphatic metastasis diagnosed by pathology as dependent variable, primary focus and PTC as independent variable. Correlation analysis between ultrasonic signs of primary focus of PTC indicating cervical lymphatic metastasis and of lymph node itself was performed. Results The microcalcifications and calcification of primary PTC, as well as cystic portions within cervical lymph node were closely related with cervical lymph node metastasis by univariate and multivariate analysis (χ2=45. 21, 48. 78, 57. 81; OR = 32. 49, 50. 73, 246. 60; all P< 0. 05). Degrees of coincidence with pathological results were good (k = 0. 57, 0. 56, 0. 64; all P<0. 01). Conclusion The microcalcifications and calcification of primary PTC, as well as cystic portions within cervical lymph node are useful for predicting lymph node metastasis of PTC before operation.%目的 探讨甲状腺乳头状癌(PTC)原发灶超声征象与颈部淋巴结转移的关系.方法 对135例PTC患者的术前超声征象进行分析,其中41例伴颈部淋巴结转移者为转移组,94例无颈部淋巴结转移者为对照组.对超声征象与病理的吻合度进行k系数检验.以病理诊断颈部淋巴结转移为因变量,以原发灶和颈部转移淋巴结声像图特征为自变量建立Logistic回归模型.对PTC原发灶的超声征象与颈部淋巴结转移征象进行相关分析.结果 单因素和多因素分析显示原发灶内微钙化、颈部淋巴结内钙化、淋巴结内囊变坏死与颈部淋巴结转移密切相关(x2 =45.21、48.78、57.81,OR=32.49、50.73、246.60,P均＜0.05),且与病理结果有较好的吻合度(k=0.57、0.56、0.64,P均＜0.01).结论 PTC原发灶内微钙化和颈部淋巴结囊变坏死、钙化对术前预测有无颈部淋巴结转移具有重要价值.
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