Zhong Minying, Zhang Zhaoming, Xiao Yisheng, He Yanping, Chen Yongyu, Huang WeiJun, Lu Liping
Department of Ultrasound, The First People's Hospital of Foshan, Foshan 528000, China.
Department of Orthopedics, Affiliated Foshan Hospital, Guangzhou University of Traditional Chinese Medicine, Foshan 528000, China.
Int J Endocrinol. 2022 Feb 7;2022:4412725. doi: 10.1155/2022/4412725. eCollection 2022.
The aim of this retrospective study was to evaluate the risk factors for central lymph node metastasis (CLNM) in papillary thyroid carcinoma (PTC), according to the guidelines of the 2017 Thyroid Imaging Report and Data System (TI-RADS) published by the American College of Radiology (ACR).
This study included a retrospective analysis of 844 patients with PTC who were pathologically diagnosed, treated with central lymph node dissection, and divided into CLNM and nonmetastatic groups. Univariate and multivariate analyses were performed to determine the relationship between the TI-RADS score and CLNM.
Among 844 patients, 439 developed CLNM, with a metastasis rate of 52% and a TI-RADS score of 9.42 ± 2.262, which were higher than those of the non-CLNM group ( < 0.05). Univariate analysis demonstrated that the sex, location, maximum diameter of the nodule, multifocality, margin, shape, calcification, and TI-RADS score were related to CLNM ( < 0.05 for all). However, multivariate logistic regression analysis demonstrated that female, maximum diameter of the nodule, multifocality, a taller-than-wide shape, and high TI-RADS score were the independent risk factors for CLNM ( < 0.05 for all).
The TI-RADS score combined with sex, nodule size, shape, and multifocality has a certain predictive effect on CLNM, which can provide a reference to the clinicians for further treatment strategies.
本回顾性研究旨在根据美国放射学会（ACR）发布的2017年甲状腺影像报告和数据系统（TI-RADS）指南，评估甲状腺乳头状癌（PTC）中央区淋巴结转移（CLNM）的危险因素。
本研究对844例经病理诊断、接受中央区淋巴结清扫术的PTC患者进行回顾性分析，将其分为CLNM组和非转移组。进行单因素和多因素分析以确定TI-RADS评分与CLNM之间的关系。
844例患者中，439例发生CLNM，转移率为52%，TI-RADS评分为9.42±2.262，均高于非CLNM组（P<0.05）。单因素分析表明，性别、位置、结节最大直径、多灶性、边缘、形状、钙化及TI-RADS评分均与CLNM有关（均P<0.05）。然而，多因素logistic回归分析表明，女性、结节最大直径、多灶性、高宽比大于1的形状及高TI-RADS评分是CLNM的独立危险因素（均P<0.05）。
TI-RADS评分联合性别、结节大小、形状及多灶性对CLNM具有一定的预测作用，可为临床医生制定进一步治疗策略提供参考。
