The Study Of The Correlation Between Characteristics Of Papillary Thyroid Carcinoma With Hashimoto’s Thyroiditis And It’s Lymph Nodes Metastasis

Objective:To explore the correlation between the characteristics of clinic,gray-scale sonography,ultrasond elastography and contrast-enhanced ultrasound of papillary thyroid carcinoma(PTC)and it’s lymph nodes metastasis(LNM).Compare and analyze the metastasis risk and risk factors of PTC cervical lymph node metastasis,which with and without hashimoto’s thyroiditis(HT).Methods:The PTC patients which were examinted in our hospital and confirmed by surgical pathology during January 2016 to December 2017 were choosed.Based on the inclusion and exclusion criteria,211 PTC patients were included in this study.We analyzed the PTC patients’ gender,age,with or without hashimoto’s thyroiditis.In the grayscale ultrasound,we focused on the tumour size,echogenicity,echotexture,margin,A/T,with or without microcalcification and microcalcification grade.In ultrasound elastography,the elasticity score of PTC nodule were evaluated.In contrast-enhanced ultrasound,mainly analyzed nodules’ contrast enhancement,enhance uniformity,the integrity of the thyroid capsule around the nodules.Then according to PTC patients coexisted with HT whether or not,all patients were divided into hashimoto background PTC group(HT group)and normal background PTC group.The risk factors of cervical lymph node metastasis in two groups were studied respectively.Multivariate analyses using binary logistic regression analysis.P<0.05 was considered statistically significant.Results:(1)Of 211 PTC patients,83 cases had LNM and 128 cases had no LNM.Multivariate analysis suggested that,gender(OR=2.329),age(OR=2.450),microcalcification grade,thyroid capsule integrity around cancer nodules(OR=2.998)were risk factors for LNM in PTC patients.HT(OR=0.427)was a protective factor of LNM in PTC.(2)Of 98 PTC patients with hashimoto background,30 cases had LNM and 68 cases had no LNM.Multivariate analysis suggested that,gender(OR=4.910),age(OR=4.235),microcalcification grade three and above(grade three OR=18.288,grade four OR=18.866)were risk factors for LNM in PTC patients with hashimoto’s thyroiditis.(3)Of 113 PTC patients with normal background,53 cases had LNM and 60 cases had no LNM.Multivariate analysis suggested that,microcalcification grade three and above(grade three OR=8.464,grade four OR=23.119),the integrity of thyroid capsule around cancer nodules(OR=5.684)were risk factors for LNM in PTC patients with normal backgroup.Conclusion:(1)The rate of LNM was considerably lower in cases PTC with HT than without HT.(2)Male sex,younger age(≤45 years old),microcalcification grade three and above were risk factors for LNM in PTC patients with HT.(3)Microcalcification grade three and above,and the thyroid capsule around the nodule interrupted were risk factors for LNM in PTC patients with normal backgroup.