中国免疫学杂志2025，Vol.41Issue(3)：661-667,7.DOI:10.3969/j.issn.1000-484X.2025.03.026
甲状腺乳头状癌合并桥本甲状腺炎与患者颈侧区淋巴结转移的关联研究
Association study between papillary thyroid carcinoma combined with Hashimoto's thyroiditis and lateral lymph node metastasis in patients
摘要
Abstract
Objective:To explore the risk factors and prediction model of lateral lymph node metastasis(LLNM)in Hashimo-to's thyroiditis(HT)combined with papillary thyroid carcinoma(PTC).By investigating its risk factors in a multi-dimensional and sys-tematic manner,a precise prediction model with clinical application value will be constructed to provide a basis for clinical diagnosis and treatment,prognosis assessment,and surgical practice decision evaluation.Methods:A retrospective analysis was conducted on the clinical data of 201 patients with HT combined with PTC who were admitted to the Thyroid Surgery Department of the First Affiliated Hospital of Jinzhou Medical University from April 2022 to June 2024.According to whether the patients had LLNM,they were divided into a metastasis group(n=82)and a non-metastasis group(n=119).The relevant clinical indicators of the two groups of patients were compared.Univariate and multivariate analyses were used to identify the independent risk factors affecting the occurrence of LLNM in patients.A logistic regression was employed to establish a prediction model and evaluate its predictive value.Results:The results of univariate analysis showed that there were statistically significant differences between the two groups in terms of TSH value,nodule lo-cation,nodule echo,shape,boundary,aspect ratio,tumor diameter,multifocality,microcalcification,rich blood supply of nodules,ELN,CLNM,capsule invasion,and ETE(P<0.05).The results of multivariate logistic regression analysis indicated that tumor diam-eter,CLNM,rich blood supply of nodules,multifocality,and TSH were all independent risk factors for LLNM(P<0.05).The receiv-er operating characteristic(ROC)curve analysis demonstrated that the areas under the curve(AUC)of tumor diameter,multifocality,CLNM,rich blood supply of nodules,and TSH were 0.613(95%CI:0.533～0.693),0.656(95%CI:0.578～0.733),0.694(95%CI:0.619～0.768),0.622(95%CI:0.543～0.701)and 0.588(95%CI:0.510～0.667),respectively.The sensitivities were 72.20%,69.60%,65.80%,60.80%and 41.80%,respectively and the specificities were 45.90%,62.30%,73.80%,60.70%and 83.60%,respectively.Conclusion:Tumor diameter,multifocality,CLNM,rich blood supply of nodules and TSH are significantly associated with the occur-rence of LLNM in patients with HT combined with PTC.Among them,tumor diameter and multifocality had relatively high sensitivities in predicting LLNM and has a certain predictive value for the occurrence of LLNM in patients with HT combined with PTC.关键词
甲状腺乳头状癌(PTC)/桥本甲状腺炎(HT)/颈侧区淋巴结转移(LLNM)/列线图/危险因素/验证Key words
Papillary thyroid carcinoma(PTC)/Hashimoto's thyroiditis(HT)/Lateral lymph node metastasis(LLNM)/Co-lumnar graph/Risk factors/Validation分类
医药卫生引用本文复制引用
刘淑珍,王俊,李纪男..甲状腺乳头状癌合并桥本甲状腺炎与患者颈侧区淋巴结转移的关联研究[J].中国免疫学杂志,2025,41(3):661-667,7.基金项目
锦州市科技计划项目(JZ2023B051). （JZ2023B051）
