朱琳,严继萍,王金萍,刘莎.基于临床、超声及基因特征列线图预测甲状腺乳头状癌侵袭性[J].中国介入影像与治疗学,2022,19(6):356-360
基于临床、超声及基因特征列线图预测甲状腺乳头状癌侵袭性
Nomogram based on clinical, ultrasonic and genetic characteristics for predicting invasiveness of papillary thyroid carcinoma
投稿时间:2022-01-11  修订日期:2022-03-23
DOI:10.13929/j.issn.1672-8475.2022.06.009
中文关键词:  甲状腺癌,乳头状  列线图  BRAF基因突变  超声检查
英文关键词:thyroid cancer, papillary  nomogram  BRAF mutation  ultrasonography
基金项目:
作者单位E-mail
朱琳 山西医科大学医学影像学院, 山西 太原 030001  
严继萍 山西医科大学医学影像学院, 山西 太原 030001
山西省人民医院超声科, 山西 太原 030012 
13593157054@163.com 
王金萍 山西省人民医院超声科, 山西 太原 030012  
刘莎 山西省人民医院超声科, 山西 太原 030012  
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中文摘要:
      目的 观察基于临床、超声及基因特征的列线图预测甲状腺乳头状癌(PTC)侵袭性的价值。方法 回顾性分析207例PTC患者,根据术后病理所示病灶侵及甲状腺被膜和/或发生患侧颈部淋巴结转移与否分为侵袭组(n=130)及非侵袭组(n=77);对比2组临床、超声及基因特征,筛选PTC侵袭性的危险因素,并以之建立列线图模型,观察其预测PTC侵袭性风险的价值。结果 2组患者年龄,结节最大径、与被膜直线距离、微钙化、数目和分布,以及BRAF V600E基因检测差异均有统计学意义(P均<0.05)。结节最大径>1 cm[OR=2.540,95%CI(1.341,4.810),P=0.004]、微钙化[OR=2.276,95%CI(1.203,4.308),P=0.011]、双侧叶多灶[OR=3.414,95%CI(1.578,7.385),P=0.002]及突变型BRAF V600E[OR=2.663,95%CI(1.147,6.182),P=0.023]为PTC侵袭性的独立危险因素。列线图模型预测PTC侵袭性的曲线下面积为0.747[95%CI(0.679,0.815)]。结论 以基于结节最大径、微钙化、数目和分布及BRAF V600E基因检测的列线图预测PTC侵袭性具有一定价值。
英文摘要:
      Objective To observe the value of nomogram based on clinical, ultrasonic and genetic characteristics for predicting invasiveness of papillary thyroid carcinoma (PTC). Methods Data of 207 PTC patients were retrospectively analyzed. The patients were divided into invasive group (n=130) and non-invasive group (n=77) according to invaded thyroid capsule and/or cervical lymph node metastasis on the affected side showed of postoperative pathology. The clinical, ultrasonic and genetic characteristics were observed between groups to screen the risk factors of PTC invasiveness. Then the nomogram model was established, and its value for predicting the invasiveness of PTC was observed. Results There were significant differences of age, the maximum diameter, linear distance from capsule, micro-calcification, number and distribution of nodule and BRAF V600E gene detection between groups (all P<0.05). The maximum diameter >1 cm (OR=2.540, 95%CI [1.341, 4.810], P=0.004), micro-calcification (OR=2.276, 95%CI [1.203, 4.308], P=0.011), bilateral lobe multifocal lesions (OR=3.414, 95%CI [1.578, 7.385], P=0.002) and mutant BRAF V600E (OR=2.663, 95%CI [1.147, 6.182], P=0.023) were all independent risk factors for PTC invasiveness. The area under the curve of nomogram model for predicting the invasive risk of PTC was 0.747 (95%CI [0.679, 0.815]). Conclusion Nomogram based on the maximum diameter, micro-calcification, number and distribution of nodules and BRAF V600E gene detection had a certain value for predicting invasiveness of PTC.
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