Gao Luying, Xi Xuehua, Gao Qiong, Tang Jiajia, Yang Xiao, Zhu Shenling, Zhao Ruina, Lai Xingjian, Zhang Xiaoyan, Zhang Bo, Jiang Yuxin
Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Department of Ultrasound, China-Japan Friendship Hospital, Beijing, China.
Front Oncol. 2021 Jan 8;10:546378. doi: 10.3389/fonc.2020.546378. eCollection 2020.
Contrast-enhanced ultrasound (CEUS) can be used to evaluate microcirculation in cancers, which in turn is associated with the biologic features and ultimately patient prognosis. We conducted a retrospective analysis to examine potential association between CEUS parameters and prognosis in patients with papillary thyroid cancer (PTC). The analysis included 306 patients who underwent CEUS prior to thyroidectomy at our center during a period from 2012 to 2019. Subjects with excellent response (ER) were compared to the non-ER group (including indeterminate response, biochemical incomplete response and structural incomplete response). During the median follow-up of 34 months, ER was observed in 195 (63.7%) subjects. The remaining 111 (36.3%) patients developed non-ER events, with distant metastasis in five (1.6%) cases. In a multivariate COX regression, non-ER event was associated with the male sex (OR = 1.83, 95%CI: 1.21-2.76) and blood-rich enhancement in CEUS (OR = 1.69, 95%CI: 1.04-2.75). Based on this finding, we developed a predictive model: high risk for developing non-ER events was defined as having both risk factors; low risk was defined as having none or only one risk. In receiver operating characteristic (ROC) analysis, the area under the curve was 0.59 (95%CI: 0.52-0.66). The sensitivity and specificity were 17.1 and 95.4%, respectively. The positive and negative predictive values were 67.9 and 66.9%, respectively. In conclusion, blood-rich enhancement in CEUS is associated with non-ER events after thyroidectomy in patients with PTC.
超声造影（CEUS）可用于评估癌症中的微循环，而微循环又与生物学特征以及最终的患者预后相关。我们进行了一项回顾性分析，以研究CEUS参数与甲状腺乳头状癌（PTC）患者预后之间的潜在关联。该分析纳入了2012年至2019年期间在我们中心接受甲状腺切除术前行CEUS检查的306例患者。将反应良好（ER）的受试者与非ER组（包括不确定反应、生化不完全反应和结构不完全反应）进行比较。在34个月的中位随访期内，195例（63.7%）受试者出现ER。其余111例（36.3%）患者发生非ER事件，其中5例（1.6%）发生远处转移。在多变量COX回归分析中，非ER事件与男性性别（OR = 1.83，95%CI：1.21 - 2.76）及CEUS中富血供增强有关（OR = 1.69，95%CI：1.04 - 2.75）。基于这一发现，我们建立了一个预测模型：将同时具有两种危险因素定义为发生非ER事件的高风险；将无危险因素或仅有一个危险因素定义为低风险。在受试者工作特征（ROC）分析中，曲线下面积为0.59（95%CI：0.52 - 0.66）。敏感性和特异性分别为17.1%和95.4%。阳性预测值和阴性预测值分别为67.9%和66.9%。总之，CEUS中的富血供增强与PTC患者甲状腺切除术后的非ER事件相关。
