| 路剑飞,曹易凡,姜芳倩,等.甲状腺微小乳头状癌 746例颈淋巴结转移的危险因素分析[J].安徽医药,2023,27(11):2216-2220. |
| 甲状腺微小乳头状癌 746例颈淋巴结转移的危险因素分析 |
| Risk factors analysis of cervical lymph node metastasis in 746 cases of thyroid micropapillary carcinoma |
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| DOI：10.3969/j.issn.1009-6469.2023.11.021 |
| 中文关键词: 甲状腺肿瘤 癌，乳头状 颈部淋巴结转移 甲状腺切除术 危险因素 |
| 英文关键词: Thyroid neoplasms Carcinoma,papillary Cervical lymph node metastasis Thyroidectomy Risk factors |
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| 摘要点击次数: 182 |
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| 中文摘要: |
| 目的讨论并分析甲状腺微小乳头状癌( PTMC)病人出现头颈部区域转移性淋巴结的危险因素。方法收集 2020年 9月至 2021年 9月蚌埠医学院第一附属医院首次就诊的甲状腺微小乳头状癌病人 746例的临床与病理资料，分析其性别、年龄、肿瘤大小、病灶数目、肿瘤侧别、包膜侵犯、合并桥本甲状腺炎( HT)等因素与颈部淋巴结转移的相关性。结果单因素分析表明，年龄 <55岁、男性、多病灶、双侧癌、侵犯包膜、肿瘤长径 >5 mm、合并 HT的病人与中央区淋巴结转移有关(均 P<0.05)；男性、多病灶、侵犯包膜、肿瘤长径 >5 mm的病人与侧颈区淋巴结转移有关(均 P<0.05)。多因素分析提示，中央区淋巴结转移的独立危险因素与肿瘤长径 >5 mm、多病灶、双侧癌密切相关(均 P<0.05)；而侧颈区淋巴结转移的独立危险因素与肿瘤长径 >5 mm、侵犯包膜和多病灶密切相关(P<0.05)。结论当 PTMC病人存在年龄 <55岁、男性、肿瘤长径 >5 mm、多病灶、双侧癌、侵犯包膜、合并 HT等情况时，应对中央区淋巴结进行外科干预，另外可参考颈淋巴结超声、 CT等相关辅助检查，有针对地进行侧颈区淋巴结清扫术。 |
| 英文摘要: |
| Objective To discuss and analyze the risk factors for metastatic lymph nodes in the head and neck region in patientswith papillary thyroid microcarcinoma (PTMC).Methods The clinical and pathological data of 746 patients with papillary thyroid microcarcinoma who first visited the Department of Oncology, the First Affiliated Hospital of Bengbu Medical College from September2020 to September 2021 were collected. The correlation between the factors such as gender, age, tumor size, number of lesions, tumorside, capsular invasion, combined Hashimoto′s thyroiditis (HT) and cervical lymph node metastasis was analyzed.Results Univariate analysis showed that age <55 years old, male, multiple lesions, bilateral cancer, encapsulation invasion, tumor diameter >5 mm, and patients with HT were associated with central lymph node metastasis (all P<0.05). Male, multi-focal, encapsulated, and tumor diameter >5 mm were associated with lateral neck lymph node metastasis (all P<0.05). Multivariate analysis showed that the independent risk factors of lymph node metastasis in the central region were closely related to tumor diameter>5 mm, multiple lesions, and bilateral cancer(all P<0.05). The independent risk factors of lymph node metastasis in lateral neck were closely related to tumor diameter>5 mm, encapsulation invasion and multiple lesions (P<0.05).Conclusions When PTMC patients are younger than 55 years old, male, tumor diameter >5 mm, multifocal, bilateral cancer, capsule invasion, combined with HT, etc., surgical intervention should be performed on thecentral lymph nodes. In addition, reference to cervical lymph node ultrasound, CT and other related auxiliary examinations can be usedto perform lateral neck lymph node dissection in a targeted manner. |
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