Kim Hankyul, Shin Jung Hee, Hahn Soo Yeon, Oh Young Lyun, Kim Sun Wook, Park Ko Woon, Lim Yaeji
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Head Neck. 2019 Aug;41(8):2507-2513. doi: 10.1002/hed.25721. Epub 2019 Mar 19.
Only clinicopathological findings are reported for predicting follicular thyroid carcinoma (FTC) associated with distant metastasis, and preoperative ultrasound (US) findings are unknown.
Associations between distant metastases of FTC and predicting factors were evaluated by using logistic regression analysis in the preoperative and postoperative models.
Distant metastasis was present in 37 (11.5%) of the 321 patients with FTC. In the preoperative model, independent predictors of distant metastasis were age, marked hypoechogenicity, nodule-in-nodule appearance, and rim calcification on US. Postoperative predictors were marked hypoechogenicity, rim calcification, and widely invasive histology. Sensitivities, specificities, and the area under the curves for predicting distant metastasis were 86.5%, 80.3%, and 0.889 on preoperative status and 86.5%, 78.5%, and 0.908 on postoperative status. Although not statistically significant, all four patients with gross extrathyroidal extension had metastasis.
Age, ultrasound features, and widely invasive histology allow preoperative and postoperative prediction of FTC associated with distant metastasis.
目前仅有关于预测伴有远处转移的滤泡状甲状腺癌（FTC）的临床病理结果的报道，术前超声（US）检查结果尚不清楚。
采用逻辑回归分析评估术前和术后模型中FTC远处转移与预测因素之间的关联。
321例FTC患者中，37例（11.5%）出现远处转移。在术前模型中，远处转移的独立预测因素为年龄、显著低回声、结节内结节表现及超声检查显示的边缘钙化。术后预测因素为显著低回声、边缘钙化及广泛浸润性组织学表现。术前预测远处转移的敏感性、特异性及曲线下面积分别为86.5%、80.3%和0.889，术后分别为86.5%、78.5%和0.908。尽管无统计学意义，但所有4例有甲状腺外广泛浸润的患者均发生转移。
年龄、超声特征及广泛浸润性组织学表现有助于术前和术后预测伴有远处转移的FTC。
