Ultrasound characteristics of medullary thyroid carcinoma

doi:10.3877/cma.j.issn.1672-6448.2021.03.005

Abstract

Abstract:

Objective

To analyze the ultrasound characteristics of medullary thyroid carcinoma (MTC), in order to provide a reference for the diagnosis and preoperative management of MTC.

Methods

Eighty-five MTC patients with complete ultrasound and clinical data were retrospectively selected from the Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital) from October 2009 to February 2020, and 150 PTC patients were selected from October 2019 to February 2020 as a control group. All patients underwent surgical treatment at our hospital and were diagnosed by routine pathology after surgery. Preoperative serum calcitonin test results were collected. The t-test was used to compare the differences in age and nodule size between the two groups; the χ² test was used to compare the differences in gender, edges, morphology, blood supply, and neck metastatic lymph nodes between the two groups. Factors with a statistically significant difference in univariate analysis were used for multivariate logistic regression analysis.

Results

Approximately 97.0% (65/67) of MTC patients had increased serum calcitonin to varying degrees. MTC and PTC were significantly related to gender (male/female: 46/39 vs 46/104, χ²=12.525, P＜0.001), age [(50.11±13.34) years vs (43.63±11.88) years, t=3.838, P＜0.001], and nodule size [(21.66±13.46) mm vs (14.10±9.93) mm, t=4.916, P＜0.001], and the two groups differed significantly in nodule edges (smoothed/unsmoothed: 56/29 vs 19/131, χ²=70.709, P＜0.001), shape (regular/irregular: 34/51 vs 101/49, χ²=16.582, P＜0.001), aspect ratio (＞1/≤1: 10/75 vs 46/104, χ²=10.679, P=0.001), blood supply (low/high: 20/65 vs 65/85, χ²=9.217, P=0.002), and lymph node metastasis (yes/no: 57/28 vs 75/75, χ²=6.413, P=0.011). Multivariate logistic regression analysis showed that smooth tumor edges, irregular shape, and neck lymph node metastasis were independent risk factors (OR=34.786, 95%CI: 12.552-96.405, P＜0.001; OR=0.194, 95%CI: 0.082-0.457, P＜0.001; OR=0.277, 95%CI: 0.109-0.705, P＜0.001).

Conclusion

MTC has the characteristics of being a large mass, smooth edges, irregular shape, rich blood supply, aspect ratio ≤1, and being prone to neck lymph node metastasis. Combined serum calcitonin can improve the diagnostic accuracy.

Key words: Medullary thyroid carcinoma, Ultrasound diagnosis, Papillary thyroid carcinoma

Xin Liu, Qiaodan Zhu, Junping Liu, Dong Xu, Pintong Huang. Ultrasound characteristics of medullary thyroid carcinoma[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(03): 266-271.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2021.03.005

https://chaosheng.cma-cmc.com.cn/EN/Y2021/V18/I03/266

Figures/Tables 3

变量	甲状腺髓样癌（n=85）	甲状腺乳头状癌（n=150）	统计值	P值
大小（mm， $x ¯$ ±s）	21.66±13.46	14.10±9.93	t=4.916	＜0.001
边缘（例）			χ²=70.709	＜0.001
光整	56	19
不光整	29	131
形态（例）			χ²=16.582	＜0.001
规则	34	101
不规则	51	49
与包膜关系（例）			χ²=0.550	0.458
触及	52	99
未触及	33	51
癌结节数量（例）			χ²=0.985	0.321
单发	56	89
多发	29	61
纵横比（例）			χ²=10.679	0.001
＞1	10	46
≤1	75	104
血供（例）			χ²=9.217	0.002
低	20	65
高	65	85
钙化（例）			χ²=0.003	0.957
有	53	93
无	32	57
颈部淋巴结转移（例）			χ²=6.413	0.011
是	57	75
否	28	75
仅中央区转移（例）			χ²=0.350	0.554
是	17	35
否	68	115
仅侧颈区转移（例）			χ²=0.353	0.553
是	5	5
否	80	145
中央+侧颈区转移（例）			χ²=8.259	0.004
是	35	35
否	50	115

变量	甲状腺髓样癌（n=85）	甲状腺乳头状癌（n=150）	统计值	P值
大小（mm， $x ¯$ ±s）	21.66±13.46	14.10±9.93	t=4.916	＜0.001
边缘（例）			χ²=70.709	＜0.001
光整	56	19
不光整	29	131
形态（例）			χ²=16.582	＜0.001
规则	34	101
不规则	51	49
与包膜关系（例）			χ²=0.550	0.458
触及	52	99
未触及	33	51
癌结节数量（例）			χ²=0.985	0.321
单发	56	89
多发	29	61
纵横比（例）			χ²=10.679	0.001
＞1	10	46
≤1	75	104
血供（例）			χ²=9.217	0.002
低	20	65
高	65	85
钙化（例）			χ²=0.003	0.957
有	53	93
无	32	57
颈部淋巴结转移（例）			χ²=6.413	0.011
是	57	75
否	28	75
仅中央区转移（例）			χ²=0.350	0.554
是	17	35
否	68	115
仅侧颈区转移（例）			χ²=0.353	0.553
是	5	5
否	80	145
中央+侧颈区转移（例）			χ²=8.259	0.004
是	35	35
否	50	115

超声特征	OR值	95%CI	P值
大小	0.977	0.946~1.008	0.147
边缘（光整，不光整）	34.786	12.552~96.405	＜0.001
形态（规则，不规则）	0.194	0.082~0.457	＜0.001
纵横比（＞1，≤1）	1.095	0.412~2.913	0.855
血供（低，高）	1.377	0.580~3.268	0.468
颈部淋巴结转移（是，否）	0.277	0.109~0.705	0.007

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