浙江医学2026，Vol.48Issue(5)：481-485,后插3,6.DOI:10.12056/j.issn.1006-2785.2026.48.5.2025-275
超声特征联合剪切波弹性成像预测接触包膜甲状腺乳头状癌患者中央区淋巴结转移的价值
Value of ultrasound features combined with shear wave elastography in predicting central lymph node metastasis in patients with capsule-contacting papillary thyroid carcinoma
摘要
Abstract
Objective To investigate the predictive value of ultrasound features combined with shear wave elastography(SWE)for central lymph node metastasis(CLNM)in capsule-contacting papillary thyroid carcinoma(PTC).Methods A retrospective collection was performed on 109 patients with single-focal PTC confirmed by postoperative pathology at Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University from January 2022 to December 2024.All patients underwent preoperative ultrasound showing thyroid capsule contact.Among them,44 had CLNM,while 65 did not.All patients underwent preoperative examinations and evaluations of ultrasound characteristics and SWE,including maximum nodule diameter,microcalcification,margin,capsule contact angle,capsule contact extent,protrusion of the capsule contour,and SWE parameters[maximum Young's modulus(Emax),minimum Young's modulus(Emin),mean Young's modulus(Emean)].Multivariate logistic regression was used to screen independent risk factors for CLNM,a combined prediction model was established,and ROC curve was plotted to analyze its predictive efficacy for CLNM.Results Univariate analysis showed statistically significant differences in maximum nodule diameter,microcalcification,protrusion of the capsule contour,and SWE Emax between the CLNM group and non-CLNM group(all P＜0.05).ROC curve analysis showed that the optimal cutoff value of SWE Emax was 63.1 kPa and that of maximum PTC diameter was 7.3 mm.Multivariate logistic regression revealed that capsule contact extent ≥25％,maximum PTC diameter＞7.3 mm,and Emax＞63.1 kPa were independent risk factors for CLNM in capsule-contacting PTC(all P＜0.05).The combined prediction model achieved AUC of 0.853,a sensitivity of 0.818,and a specificity of 0.800,which were higher than the predictive efficacy of each indicator alone.Conclusion Ultrasound features combined with SWE have good predictive value for CLNM in capsule-contacting PTC.Careful preoperative evaluation of these features can provide a reference for the selection of individualized clinical treatment strategies.关键词
甲状腺乳头状癌/接触包膜/剪切波弹性成像/中央区淋巴结转移Key words
Papillary thyroid carcinoma/Capsule-contacting/Shear wave elastography/Central lymph node metastasis引用本文复制引用
郭东,黄石飞,姚烨菲,张正贤,王露,单悦..超声特征联合剪切波弹性成像预测接触包膜甲状腺乳头状癌患者中央区淋巴结转移的价值[J].浙江医学,2026,48(5):481-485,后插3,6.基金项目
浙江省医药卫生科技计划项目(2023KY984) （2023KY984）
