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Title: [Prediction of occult carcinoma in contralateral nodules based on the ultrasonic features of unilateral papillary thyroid carcinoma].
Author: Yang LM, Li Q, Zhao BW, Lyu JG, Xu HS, Xu LL, Li SY, Gao L, Zhu J.
Journal: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi; 2017 Apr 07; 52(4):259-262. PubMed ID: 28441801.
Abstract:
Objective: To investigate the occurrence of occult carcinoma in contralateral lobes based on the ultrasonic features of unilateral papillary thyroid carcinoma. Methods: The study included 202 consecutives cases of unilateral papillary thyroid carcinoma with benign nodules in the contralateral lobe identified by preoperative ultrasound or fine-needle aspiration from June 2014 to December 2015. All patients received total thyroidectomies, and with postoperative pathological examination they were divided into two groups, one including 60 cases with positive occult cancer and another one consisting of 142 cases with negative occult cancer. Univariate and multivariate analyses were performed to analyze the sonographic features of unilateral papillary thyroid carcinoma relevant to the occurrence of occult carcinoma in the contralateral nodules. Results: Univariate analysis indicated occult carcinoma in the contralateral lobes was associated with Hashimoto's thyroiditis(χ(2)=3.955, P=0.047), unclear border (χ(2)=4.375, P=0.036)and multifocality in the ipsilateral(χ(2)=7.375, P=0.007), but not with tumors maximum size, location, A/T, shape, internal structure, internal echo, acoustic halo, calcification, capsular invasion and blood flow signal in the lobe with carcinoma on another side. Multivariate analysis showed unclear border (OR=2.727, P=0.010) and multifocality in the ipsilateral(OR=2.807, P=0.005)of carcinoma were independent predictive factor for contralateral occult PTC. Conclusions: Unclear border and multifocality of PTC in the ipsilateral were closely relevant to the occurrence of occult carcinoma in the contralateral nodules. 目的： 探讨单侧甲状腺乳头状癌的超声特征与对侧腺叶隐匿癌发生的关系。 方法： 回顾性分析2014年6月至2015年12月浙江大学医学院附属邵逸夫医院经超声或超声引导下细针穿刺细胞学检查诊断为单侧甲状腺乳头状癌合并对侧良性结节的202例患者的227个病灶的术前超声声像图，根据手术病理分为对侧隐匿癌阳性组60例和对侧隐匿癌阴性组142例，采用单因素和多因素分析甲状腺乳头状癌的声像图特征与对侧隐匿癌发生的关系。 结果： 单因素分析显示对侧腺叶隐匿癌的发生与同侧癌灶合并桥本甲状腺炎(χ(2)＝3.955，P＝0.047)、边界不清(χ(2)＝4.375，P＝0.036)及多灶癌(χ(2)＝7.375，P＝0.007)有关，而与同侧癌结节的最大径、位置、A/T、形态、内部结构、内部回声、声晕、钙化、是否与包膜接触及血供程度等因素均无相关性。多因素Logistic回归分析显示同侧癌灶边界不清(OR＝2.727，P＝0.010)与多灶癌(OR＝2.807，P＝0.005)是对侧腺体隐匿癌发生的独立危险因素。 结论： 同侧甲状腺乳头状癌边界不清和多灶癌与对侧腺体甲状腺隐匿癌的发生相关，有助于临床制定个体化的诊疗方案。.

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