The application value of ultrasound in predicting the 5-year recurrence of patients with papillary carcinoma of the thyroid combined with Hashimoto’s thyroiditis

GE Naiqiao; WANG Yuexiang; LAN Yu; JIANG Bo; MA Jun; LI Molin; LUO Yukun

doi:10.19732/j.cnki.2096-6210.2024.03.005

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The application value of ultrasound in predicting the 5-year recurrence of patients with papillary carcinoma of the thyroid combined with Hashimoto’s thyroiditis

更新时间：2025-12-15

- The application value of ultrasound in predicting the 5-year recurrence of patients with papillary carcinoma of the thyroid combined with Hashimoto’s thyroiditis
- Vol. 33, Issue 3, Pages: 239-246(2024)
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.19732/j.cnki.2096-6210.2024.03.005
  CLC：
- Published Online：16 July 2024，
  
  Published：16 July 2024
- 稿件说明：
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葛乃侨,王月香,兰雨,等. 超声在桥本甲状腺炎合并PTC患者5年复发情况预测中的应用价值[J]. 肿瘤影像学, 2024, 33(3): 239-246 https://doi.

org/10.19732/j.cnki.2096-6210.2024.03.005
葛乃侨,王月香,兰雨,等. 超声在桥本甲状腺炎合并PTC患者5年复发情况预测中的应用价值[J]. 肿瘤影像学, 2024, 33(3): 239-246 https://doi. DOI： 10.19732/j.cnki.2096-6210.2024.03.005.

org/10.19732/j.cnki.2096-6210.2024.03.005 DOI：

摘要

目的：

探讨超声在预测桥本甲状腺炎（Hashimoto’s thyroiditis，HT）合并甲状腺乳头状癌（papillary carcinoma of the thyroid，PTC）患者（以下简称HTPTC）术后5年复发情况中的应用价值，并建立预测模型。

方法：

收集并分析292例经手术治疗的HTPTC患者的超声及临床资料，记录患者复发情况，中位随访时间5.42年，复发定义为经细针穿刺活检（fine-needle aspiration biopsy，FNAB）或二次手术后的病理学检查确诊新病灶或异常淋巴结中存在癌细胞。采用单因素Cox回归分析确定与5年复发相关的潜在预测因素，纳入多因素Cox回归分析，识别出与复发相关的独立预测因素，构建并评估预测模型。

结果：

Cox单因素回归分析结果显示结节最大径、形状、边缘、钙化情况、超声血流情况、恶性结节数量、接触被膜情况是与5年复发相关的潜在预测因素。Cox多因素回归分析结果证实，结节最大径＞1.5 cm［HR=3.37（95% CI 1.17~9.68），

=0.023］、结节纵横比＞1［HR=4.82（95% CI 1.69~13.75），

=0.003］、微钙化［HR=5.51（95% CI 1.18~25.68），

=0.029］及恶性结节多灶［HR=3.28（95% CI 1.03~10.47），

=0.045］是HTPTC患者5年复发的独立预测因素，应用以上变量建立HTPTC患者复发的预测模型，该模型的C指数为0.845（标准误=0.061），第3年的受试者工作特征（receiver operating characteristic，ROC）曲线的曲线下面积为0.767（95% CI 0.502~1.000），第5年为0.834（95% CI 0.695~0.943）。

结论：

基于超声特征的预测模型为HTPTC患者的复发风险评估提供了新的方法，有助于医师在术前为患者制订个性化治疗方案，以减少过度治疗。

Abstract

Obejetive:

To investigate the value of ultrasound in predi

cting the 5-year postoperative recurrence of patients with Hashimoto’s thyroiditis (HT) combined with papillary carcinoma of the thyroid (PTC)

hereinafter referred to as HTPTC

and to establish a prediction model.

Methods:

The ultrasound and clinical data of 292 HTPTC patients treated surgically were collected and analyzed. The recurrence of patients was recorded

with a median follow-up time of 5.42 years. Recurrence was defined as the presence of cancer cells in new lesions or abnormal lymph nodes confirmed by fine-needle aspiration biopsy (FNAB) or pathology results after a second surgery. Univariate Cox regression analysis was used to determine potential predictors related to 5-year recurrence

which were then included in a multivariate Cox regression analysis to identify independent predictors of recurrence and to construct and evaluate a prediction model.

Results:

The multivariate Cox regression analysis confirmed that a nodule maximum diameter greater than 1.5 cm (HR=3.37

95% CI 1.17-9.68

=0.023)

a nodule aspect ratio greater than 1 (HR=4.82

95% CI 1.69- 13.75

=0.003)

microcalcification (HR=5.51

95% CI 1.18-25.68

=0.029)

and multifocal malignant nodules (HR=3.28

95% CI 1.03-10.47

=0.045) were independent predictors of 5-year recurrence in HTPTC patients. Using these variables

a prediction model for recurrence in HTPTC patients was established. The C-index of the model was 0.845 (SE=0.061). The area under the receiver operating characteristic (ROC) curve was 0.767 (95% CI 0.502-1.000) for the third year and 0.834 (95% CI 0.695-0.943) for the fifth year.

Conclusion:

The ultrasound-based predictive model provides a new method for assessing the recurrence risk in HTPTC patients

aiding doctors in personalizing preoperative planning for patients to reduce overtreatment.

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