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[甲状腺乳头状癌常规超声特征与BRAFV600E基因突变及中央区淋巴结转移的相关性]

[Correlation between conventional ultrasound features and BRAFV600E gene mutation and central lymph node metastasis in thyroid papillary carcinoma].

作者信息

Zhang Jie, Feng Yanhong, He Xiuli, Bai Qinwen, Lv Yang, Sun Kemin, Qi Ming

机构信息

Department of Ultrasound,the First Affiliated Hospital of Jinzhou Medical University,Jinzhou,121000,China.

Department of Ultrasound,the First Affiliated Hospital of Nanchang University.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Mar;36(3):184-188. doi: 10.13201/j.issn.2096-7993.2022.03.006.

Abstract

To investigate whether central lymph node metastasis(CLNM) in the central region of thyroid papillary carcinoma(PTC) is related to conventional ultrasound features of the primary lesion and BRAFV600E gene mutation. A total of 300 patients with PTC confirmed by surgical pathology and central lymph node dissection in the First Affiliated Hospital of Jinzhou Medical University from October 2019 to June 2021 were collected. The subjects were divided into the metastatic group and the non-metastatic group according to whether CLNM occurred. The correlation was determined by analyzing the conventional ultrasound characteristics and BRAFV600E gene test results of the two groups of patients. Among 300 PTC patients, 120(40%) had CLNM. Univariate analysis showed that there were statistically significant differences between groups in gender, nodule maximum diameter line, number of lesions, boundaries, morphology, aspect ratio, proximity to the membrane, calcification and BRAFV600E gene mutation(<0.05). Logistic multivariate regression analysis showed that gender, maximum diameter line, aspect ratio, proximity to the membrane, microcalcification and BRAFV600E were the risk factors for CLNM in PTC patients(<0.05). ROC curve showed that when the maximum diameter was 8.5 mm, the Yooden index was the maximum. When the risk factors of male, maximum diameter ≥8.5 mm, aspect ratio ≥1, microcalcification, proximity to capsule and BRAFV600E(+) appear in PTC patients, high attention should be paid to preventive CLN dissection as soon as possible.

摘要

探讨甲状腺乳头状癌(PTC)中央区中央淋巴结转移(CLNM)是否与原发灶的常规超声特征及BRAFV600E基因突变有关。收集2019年10月至2021年6月在锦州医科大学附属第一医院经手术病理及中央淋巴结清扫确诊的300例PTC患者。根据是否发生CLNM将研究对象分为转移组和非转移组。通过分析两组患者的常规超声特征及BRAFV600E基因检测结果来确定相关性。300例PTC患者中,120例(40%)发生CLNM。单因素分析显示,两组在性别、结节最大径线、病灶数量、边界、形态、纵横比、靠近被膜情况、钙化及BRAFV600E基因突变方面差异有统计学意义(P<0.05)。Logistic多因素回归分析显示,性别、最大径线、纵横比、靠近被膜情况、微钙化及BRAFV600E是PTC患者发生CLNM的危险因素(P<0.05)。ROC曲线显示,最大径为8.5 mm时约登指数最大。当PTC患者出现男性、最大径≥8.5 mm、纵横比≥1、微钙化、靠近被膜及BRAFV600E(+)等危险因素时,应尽早高度重视预防性中央淋巴结清扫。

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