Yang L M, Li Q, Zhao B W, Lyu J G, Xu H S, Xu L L, Li S Y, Gao L, Zhu J
Department of Diagnostic Ultrasound, Sir Run Run Shaw Hospital of Zhejiang University College of Medicine &Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University, Hangzhou 310016, China.
Department of Head and Neck Surgery, Sir Run Run Shaw Hospital of Zhejiang University College of Medicine &Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University, Hangzhou 310016, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Apr 7;52(4):259-262. doi: 10.3760/cma.j.issn.1673-0860.2017.04.004.
To investigate the occurrence of occult carcinoma in contralateral lobes based on the ultrasonic features of unilateral papillary thyroid carcinoma. The study included 202 consecutives cases of unilateral papillary thyroid carcinoma with benign nodules in the contralateral lobe identified by preoperative ultrasound or fine-needle aspiration from June 2014 to December 2015. All patients received total thyroidectomies, and with postoperative pathological examination they were divided into two groups, one including 60 cases with positive occult cancer and another one consisting of 142 cases with negative occult cancer. Univariate and multivariate analyses were performed to analyze the sonographic features of unilateral papillary thyroid carcinoma relevant to the occurrence of occult carcinoma in the contralateral nodules. Univariate analysis indicated occult carcinoma in the contralateral lobes was associated with Hashimoto's thyroiditis(χ(2)=3.955, =0.047), unclear border (χ(2)=4.375, =0.036)and multifocality in the ipsilateral(χ(2)=7.375, =0.007), but not with tumors maximum size, location, A/T, shape, internal structure, internal echo, acoustic halo, calcification, capsular invasion and blood flow signal in the lobe with carcinoma on another side. Multivariate analysis showed unclear border (=2.727, =0.010) and multifocality in the ipsilateral(=2.807, =0.005)of carcinoma were independent predictive factor for contralateral occult PTC. Unclear border and multifocality of PTC in the ipsilateral were closely relevant to the occurrence of occult carcinoma in the contralateral nodules.
基于单侧甲状腺乳头状癌的超声特征,探讨对侧叶隐匿性癌的发生情况。本研究纳入了2014年6月至2015年12月期间连续收治的202例单侧甲状腺乳头状癌患者,这些患者术前超声或细针穿刺检查显示对侧叶有良性结节。所有患者均接受了全甲状腺切除术,并根据术后病理检查分为两组,一组为60例隐匿癌阳性患者,另一组为142例隐匿癌阴性患者。进行单因素和多因素分析,以分析单侧甲状腺乳头状癌与对侧结节隐匿性癌发生相关的超声特征。单因素分析表明,对侧叶隐匿性癌与桥本甲状腺炎(χ(2)=3.955,P =0.047)、边界不清(χ(2)=4.375,P =0.036)以及同侧多灶性(χ(2)=7.375,P =0.007)有关,但与另一侧癌灶所在叶的肿瘤最大径、位置、纵横比、形态、内部结构、内部回声、声晕、钙化、包膜侵犯及血流信号无关。多因素分析显示,癌灶边界不清(β=2.727,P =0.010)和同侧多灶性(β=2.807,P =0.005)是对侧隐匿性甲状腺乳头状癌的独立预测因素。同侧甲状腺乳头状癌的边界不清和多灶性与对侧结节隐匿性癌的发生密切相关。