意外甲状腺癌的临床病理特点及预测因素：附523例报告

目的:通过超声影像和病理特征探讨意外甲状腺癌预测因素。方法:回顾性分析2014年1月—2014年10月期间于哈尔滨医科大学附属第一医院收治的523例甲状腺癌患者的临床病理资料,其中意外甲状腺癌患者108例(观察组),非意外甲状腺癌患者415例(对照组),比较两组患者之间临床病理特点的差异。结果:两组在年龄、病灶数量、病理分型、病变结构、是否合并良性甲状腺疾病、是否钙化、癌灶颜色、纵横比、弹性评分、边界情况、回声强度、是否清扫中央组淋巴结的构成比均有统计学差异(均P0.05);Logistic回归分析显示,滤泡状癌、无钙化、纵横比1、边界清晰、非低回声、弹性评分3、癌灶直径与癌灶所在结节的直径比值30%是意外甲状腺癌发生的预测因素(均P0.05)。结论:滤泡状甲状腺癌、无钙化、纵横比1、边界清晰、非低回声、弹性评分3、癌径比30%等是意外甲状腺癌的预测因素。

Clinicopathologic features and predictive factors of incidental thyroid carcinoma: a report of 523 cases

Objective: To investigate the predictive factors for incidental thyroid carcinoma through its ultrasonic and pathological features. Methods: The clinicopathologic data of 541 patients with thyroid cancer treated in the First Affiliated Hospital of Harbin Medical University between January 2014 and October 2014 were retrospectively analyzed. Of the patients, 108 cases were incidental thyroid carcinoma (observational group), and 421 cases were non- incidental thyroid carcinoma (control group). Differences in clinicopathologic features between the two groups of patients were compared.Results: There was significant difference between the two groups in the proportions of age, number of lesions, pathological classification, structure of lesions, whether or not combined with benign thyroid disease, presence or absence of calcification, color of lesion, aspect ratio of nodules, elasticity score, boundary conditions, echo intensity, whether or not lymph node dissection of the central compartment was performed (all P<0.05). Logistic regression analysis revealed that follicular carcinoma, absence of calcification, aspect ratio less than 1, clear boundaries, non-hypoecho, elasticity score less than 3 and the ratio between the diameter of tumor and tumor-bearing nodule less than 30% were predictive factors for incidental thyroid carcinoma (all P<0.05).Conclusion: Follicular carcinoma, absence of calcification, length to width ratio less than 1, clear boundaries, non-hypoecho, elasticity score less than 3 and the ratio between the diameter of tumor and tumor-bearing nodule less than 30% are predictive factors for incidental thyroid carcinoma.