Risk factor analysis of recurrent laryngeal nerve invasion in papillary thyroid carcinoma based on ultrasound image characteristics(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2025年第9期
- Page:
- 1153-1158
- Research Field:
- 医学影像物理
- Publishing date:
Info
- Title:
- Risk factor analysis of recurrent laryngeal nerve invasion in papillary thyroid carcinoma based on ultrasound image characteristics
- Author(s):
- GUO Peixin1; JI Hongyuan1; LIU Zhi2; HE Chaoying1
- 1. Department of Ultrasound Medicine, the Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou 510130, China
2. Department of Ultrasound Diagnosis, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
- Keywords:
- Keywords: papillary thyroid carcinoma recurrent laryngeal nerve invasion ultrasound image risk factor regression equation predictive value
- PACS:
- R318；R445.1
- DOI:
- DOI:10.3969/j.issn.1005-202X.2025.09.005
- Abstract:
- Abstract: Objective To explore the risk factors for recurrent laryngeal nerve (RLN) invasion in patients with papillary thyroid carcinoma (PTC) based on ultrasound image characteristics, construct a regression equation, and explore its predictive value for providing a reference for the clinical prevention and treatment of RLN invasion in PTC patients. Methods A retrospective analysis was conducted on 1 195 patients who were pathologically diagnosed with PTC in the Affiliated TCM Hospital of Guangzhou Medical University and Nanfang Hospital, Southern Medical University from January 2020 to November 2024. These patients were divided into invasion group (n=28) and non-invasion group (n=1 167) according to whether they had RLN invasion or not. The clinical data, pathological data and ultrasound image characteristics were compared between two groups. The risk factors for RLN invasion in PTC patients were identified using multifactorial Logistic regression to construct a regression equation which was then evaluated using the likelihood ratio [χ2]. Moreover, the Hosmer-Lemeshow test was utilized to assess the goodness of fit, and the receiver operating characteristic (ROC) curve was plotted to analyze the predictive value of the regression equation for RLN invasion in PTC patients, and the area under the curve (AUC) was calculated. Results The proportions of patients with tumor located in the posterior sagittal position, maximum tumor diameter ≥ 1 cm, capsule contact and lymph node metastasis were higher in invasion group than in non-invasion group (P<0.05). Multifactorial Logistic regression analysis identified tumor located in the posterior sagittal position (OR=1.079, 95%CI: 1.031-1.129), maximum tumor diameter ≥ 1 cm (OR=2.408, 95%CI: 1.256-4.617), capsule contact (OR=3.171, 95%CI: 1.724-5.833), and lymph node metastasis (OR=3.425, 95%CI: 1.884-6.226) as independent risk factors for RLN invasion in PTC patients (P<0.05). The regression equation was constructed as followed: logit (P) = -8.552 + tumor located in the posterior sagittal position × 0.076 + maximum tumor diameter ≥ 1 cm × 0.879 + capsule contact×1.154 + lymph node metastasis×1.231. The likelihood ratio [χ2] evaluation of the regression equation suggested that the regression equation was effectively constructed (P<0.001). Hosmer-Lemeshow test for the goodness of fit of the regression equation showed that the regression equation was well fitted (P>0.05). ROC curve analysis revealed that when logit (P) > 0.875, the AUC value was 0.901 (95%CI: 0.882-0.917), with a sensitivity of 75.00% and a specificity of 88.95%. Conclusion The occurrence of RLN invasion in PTC patients is associated with tumor located in the posterior sagittal position, maximum tumor diameter ≥ 1 cm, capsule contact, and lymph node metastasis, and the regression equations constructed based on these factors can well predict the occurrence of RLN invasion in PTC patients and is expected to provide an effective guidance for clinical practice.
Last Update: 2025-09-30