2023 年第 1 期 第 18 卷

甲状腺乳头状癌患者超声造影定量参数与临床病理特征的关系

Relationship between quantitative parameters of contrast-enhanced ultrasound and clinicopathological characteristics of patients with thyroid papillary cancer

作者：刘向辉王春莉托静美

英文作者：Liu Xianghui Wang Chunli Tuo Jingmei

单位：河北省张家口市第一医院超声科，张家口075000

英文单位：Department of Ultrasound Zhangjiakou First Hospital Hebei Province Zhangjiakou 075000 China

关键词：甲状腺乳头状癌；超声造影；定量参数；临床病理特征

英文关键词：Thyroidpapillarycancer;Contrast-enhancedultrasound;Quantitativeparameters;Clinicopathologicalcharacteristics

• 摘要：

• 目的  探讨甲状腺乳头状癌患者超声造影定量参数与临床病理特征的关系。方法 选取2019年3月至2022年3月河北省张家口市第一医院收治的经手术病理确诊的135例甲状腺癌患者作为甲状腺癌组，将其中101例甲状腺乳头状癌患者设为乳头状癌组，34例非乳头状癌患者设为非乳头状癌组，另选取同期98例甲状腺良性结节患者作为良性结节组。观察所有患者的超声造影图像特征，并通过软件获取相关定量参数，包括上升时间、峰值时间、峰值强度、曲线下面积。分别比较甲状腺癌组与良性结节组、乳头状癌组与非乳头状癌组的超声造影定量参数，另外比较不同临床病理特征的甲状腺乳头状癌患者超声造影定量参数水平的差异。结果 甲状腺癌组与良性结节组上升时间、峰值时间比较差异无统计学意义（P＞0.05），甲状腺癌组峰值强度、曲线下面积均低于良性结节组［（14.5±5.3）dB比（20.1±5.9）dB、（960±180）dB·s比（1 620±250）dB·s］（均P＜0.001）。乳头状癌组与非乳头状癌组上升时间、峰值时间比较差异均无统计学意义（均P＞0.05），乳头状癌组的峰值强度、曲线下面积均低于非乳头状癌组［（14.2±2.1）dB比（15.4±3.3）dB、（940±121）dB·s比（1 020±160）dB·s］（均P＜0.05）。甲状腺乳头状癌病理分期Ⅲ～Ⅳ期、最大肿瘤直径≥1 cm、有包膜侵犯、有淋巴结转移患者峰值强度、曲线下面积参数分别高于病理分期Ⅰ～Ⅱ期、最大肿瘤直径＜1 cm、无包膜侵犯、无淋巴结转移患者（均P＜0.05）。结论 甲状腺癌与甲状腺良性结节患者、甲状腺乳头状癌和非乳头状癌患者超声造影定量参数差异显著，且峰值强度、曲线下面积等超声造影定量参数在甲状腺乳头状癌不同临床病理特征患者中存在明显差异，可为甲状腺乳头状癌病情评估提供影像学参考依据。

• Objective To investigate the relationship between quantitative parameters of contrast-enhanced ultrasound and clinicopathological characteristics in patients with thyroid papillary cancer. Methods Totally 135 patients with thyroid cancer diagnosed by surgery and pathologic diagnosis were selected as the thyroid cancer group in Zhangjiakou First Hospital, Hebei Province from March 2019 to March 2022, of which 101 patients with papillary cancer were set as the papillary cancer group and 34 patients with non papillary cancer were set as the non papillary cancer group. Another 98 patients with benign thyroid nodules were selected as the benign nodule group. The contrast-enhanced ultrasound characteristics of all patients were observed, and the relevant quantitative parameters were obtained, including rise time (RT), time to peak (TTP), peak intensity (PI) and the area under the curve (AUC). The quantitative parameters of contrast-enhanced ultrasound were compared between thyroid cancer group and benign nodule group, papillary cancer group and non papillary cancer group. The differences of quantitative parameters of contrast-enhanced ultrasound in patients with thyroid papillary cancer with different clinicopathological characteristics were compared. Results There were no significant differences in RT and TTP between thyroid cancer group and benign nodule group (P＞0.05). The parameters of PI and AUC in thyroid cancer group were lower than those in benign nodule group［（14.5±5.3）dB vs （20.1±5.9）dB, （960±180）dB·s vs （1 620±250）dB·s］(both P＜0.001). There were no significant differences in RT and TTP between papillary cancer group and non papillary cancer group (both P＞0.05). Parameters of PI and AUC in papillary cancer group were lower than those in non papillary cancer group［（14.2±2.1）dB vs （15.4±3.3）dB, （940±121）dB·s vs （1 020±160）dB·s］(both P＜0.05). In patients with thyroid papillary cancer, PI and AUC of pathological stage Ⅲ-Ⅳ, maximum tumor diameter ≥1 cm, envelope invasion and lymph node metastasis were higher than those of pathological stage Ⅰ-Ⅱ, maximum tumor diameter＜1 cm, no envelope invasion and no lymph node metastasis respectively (all P＜0.05). Conclusions There are significant differences in quantitative parameters of contrast-enhanced ultrasound between patients with thyroid cancer and benign thyroid nodules, thyroid papillary cancer and non thyroid papillary cancer, and there are significant differences in quantitative parameters of contrast-enhanced ultrasound such as PI and AUC in patients with different clinicopathological characteristics of thyroid papillary cancer, which can provide imaging reference for the evaluation of the condition of thyroid papillary cancer.