摘要
目的:探讨微波消融甲状腺微小乳头状癌(PTMC)术后消融区吸收效果的影响因素。方法:回顾性分析2019年4月至2023年7月北京友谊医院收治的101例行微波消融治疗的单发PTMC患者的临床及超声资料,以术后1年消融区是否消失为终点事件,将其分为消失组(52例)和未消失组(49例),采用单因素及多因素logistic回归分析影响消融区吸收效果的因素,并建立回归模型,使用受试者工作特征(ROC)曲线检验模型的预测效能。结果:两组间在年龄、结节内粗钙化、消融时间以及伴有桥本氏甲状腺炎方面比较,差异均有统计学意义(χ^(2)=4.708、12.180、19.497、8.457,P<0.05);两组间在结节最大径、结节体积及消融热量方面比较,差异亦有统计学意义(Z=-3.929、-3.969、-3.677,P<0.05)。多因素logistic回归分析表明,年龄≥50岁、结节内粗钙化、消融时间≥50 s以及伴有桥本氏甲状腺炎是微波消融治疗PTMC术后1年消融区未消失的独立影响因素(OR=4.464、3.733、10.063、4.173,P<0.05)。ROC曲线分析显示,回归模型预测微波消融PTMC术后消融区未消失的曲线下面积(AUC)为0.853(95%CI:0.777~0.929),其诊断灵敏度及特异度分别为75.5%、82.7%。结论:基于临床信息、术前超声特征及热消融参数构建的logistic回归模型对预测微波消融PTMC患者术后消融区吸收情况具有较高临床应用价值。
Objective:To explore the influencing factors of absorption effect postoperative ablation area after microwave ablation(MWA)for papillary thyroid microcarcinoma(PTMC).Methods:The clinical and ultrasound data of 101 patients with single PTMC who underwent microwave ablation in Beijing Friendship Hospital between April 2019 and July 2023 were collected.According to the endpoint event of whether the ablation area disappeared one year after MWA,they were divided into disappearance group(52 cases)and non-disappearance group(49 cases).Univariate and multivariate logistic regression were used to analyze the factors of affecting the absorption effect of ablation area,and a regression model was constructed.Receiver operating characteristic(ROC)curve was drawn to test the predictive efficacy of the model.Results:There were significant differences in the age,coarse calcification in the nodule,ablation time,Hashimoto's thyroiditis between two groups(χ^(2)=4.708,12.180,19.497,8.457,P<0.05),respectively.There were also significant differences in maximum diameter of nodule,nodule volume,ablation energy between two groups(Z=-3.929,-3.969,-3.677,P<0.05).Multivariate logistic regression analysis showed that age≥50 years old,coarse calcification in the nodule,ablation time≥50s,and Hashimoto's thyroiditis were independent influencing factors for the non-disappearance of ablation area one year after MWA for PTMC(OR=4.464,3.733,10.063,4.173,P<0.05).The ROC curve analysis showed that the area under curve(AUC)of the regression model in predicting non-disappearance of ablation area after MWA for PTMC was 0.853(95%CI:0.777-0.929),and the diagnostic sensitivity and specificity of that were respectively 75.5%and 82.7%.Conclusion:The logistic regression model,that is constructed on the basis of clinical information,preoperative ultrasound features,and thermal ablation parameters,has high clinical application value in predicting the postoperative absorption of the ablation area in patients who undergo MWA for PTMC.
作者
曹欣然
郭瑞芳
杨沛沛
钱林学
Cao Xinran;Guo Ruifang;Yang Peipei;Qian Linxue(Department of Ultrasound,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《中国医学装备》
2025年第5期6-9,15,共5页
China Medical Equipment
基金
首都卫生发展科研专项(首发2022-1-2022)。
关键词
甲状腺微小乳头状癌(PTMC)
微波消融
影响因素
超声特征
Papillary thyroid microcarcinoma(PTMC)
Microwave ablation(MWA)
Influencing factor
Ultrasonography features
