| 陈立权,庞士勇,丁士海,等.甲状腺微小乳头状癌颈淋巴结转移危险因素分析及外科处理策略[J].安徽医药,2020,24(5):985-988. |
| 甲状腺微小乳头状癌颈淋巴结转移危险因素分析及外科处理策略 |
| Analysis of risk factors for cervical lymph node metastasis of thyroid micropapillary carcinoma and surgical processing strategies |
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| DOI：10.3969/j.issn.1009?6469.2020.05.035 |
| 中文关键词: 甲状腺肿瘤 甲状腺切除术 颈淋巴结清扫术 淋巴转移 超声检查，多普勒，彩色 体层摄影术， X线计算机 危险因素 外科处理策略 |
| 英文关键词: Thyroid neoplasms Thyroidectomy Neck dissection Lymphatic metastasis Ultrasonography,doppler,color Tomography,X?ray computed Risk factors Surgical management strategy |
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| 摘要点击次数: 2488 |
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| 中文摘要: |
| 目的探讨甲状腺微小乳头状癌( PTMC)颈淋巴结转移危险因素及外科处理策略。方法选取安徽医科大学附属六安医院 2014年 1月至 2018年 6月收治的 PTMC病人 106例作为研究对象，其中无淋巴结转移者 64例，淋巴结转移者 42例，包括中央区淋巴结转移者 37例，侧颈部淋巴结转移者 14例。收集所有研究对象年龄、性别、肿瘤直径、肿瘤位置、病灶情况、甲状腺包膜受侵情况等临床资料，分析甲状腺微小乳头状癌颈淋巴结转移危险因素，探讨外科处理策略。结果(1)中央区淋巴结转移危险因素:年龄、肿瘤直径、是否多灶、肿瘤位置、甲状腺包膜受侵情况与中央区淋巴结转移有关( P＜0.05)；多因素分析可知，肿瘤直径 ≥7 mm、双侧癌、多灶、包膜受侵是中央区淋巴结转移的独立危险因素( P＜0.05)；(2)侧颈区淋巴结转移危险因素:肿瘤直径、肿瘤位置、甲状腺包膜受侵情况、是否多灶与侧颈区淋巴结转移有关( P＜0.05)；多因素分析:肿瘤直径 ≥7 mm、包膜受侵、多灶、上极肿瘤是侧颈区淋巴结转移的独立危险因素( P＜0.05)。结论对于 PTMC病人而言，肿瘤直径 ≥7 mm、双侧癌、多灶、包膜受侵是中央区淋巴结转移的独立危险因素，肿瘤直径 ≥7 mm、包膜受侵、多灶、上极肿瘤是侧颈区淋巴结转移的独立危险因素，临床应根据上述对应独立危险因素判断淋巴结转移区域及危险程度，采取针对性外科处理措施，以改善预后情况。 |
| 英文摘要: |
| Objective To study the risk factors and surgical management strategies of cervical lymph node metastasis in thyroid mi? cropapillary carcinoma(PTMC).Methods A total of 106 patients with PTMC admitted to Lu’an Hospital Affiliated to Anhui Med? ical University from January 2014 to June 2018 were enrolled.Among them，64 patients had no lymph node metastasis，42 patients had lymph node metastasis，including 37patients with central lymph node metastasis，and 14 cases of lateral cervical lymph nodes transfer.The clinical data of age，gender，tumor diameter，tumor location，lesion status，and thyroid capsule invasion were collected.The risk factors forcervical lymph node metastasis of thyroid micropapillary carcinoma were analyzed，and the surgical management strategy was discussed.Results(1)Risk factors of central lymph node metastasis were related to age，tumor diameter，multifocal， tumor location，thyroid capsule invasion and central lymph node metastasis(P＜0.05)； multivariate analysis showed that tumor di?ameter ≥7 mm，bilateral cancer，multifocal，and capsule invasion were independent risk factors for central lymph node metastasis(P＜0.05)；(2)risk factors for lateral cervical lymph node metastasis were related to tumor diameter，tumor location，thyroid cap? sule invasion，multifocal and lateral cervical lymph node metastasis(P＜0.05)； multivariate analysis:tumor diameter ≥7 mm，cap? sule invasion，multifocal，upper pole tumor were independent risk factors for cervical lymph node metastasis(P＜0.05).Conclu? sion For patients with PTMC，tumor diameter ≥7 mm，bilateral cancer，multifocal，and capsular invasion are independent risk fac? tors for central lymph node metastasis.Tumor diameter ≥7 mm，capsular invasion，multifocal，and epithelial tumor are independent risk factors for lymph node metastasis in the lateral neck region.Clinically，the lymph node metastasis area and risk degree shouldbe judged according to the above?mentioned corresponding independent risk factors，and targeted surgical treatment measures should be taken to improve the prognosis. |
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