甲状腺微小乳头状癌淋巴结转移特征及其影响因素分析  

Clinical features of lymph node metastasis of thyroid papillary microcarcinoma and its related factors

作　　者：梁忠[1] 王可敬[1] 赵坚强[1] 赵明[1] 

机构地区：[1]浙江省肿瘤医院头颈外科,杭州310022

出　　处：《浙江医学》2015年第11期931-933,944,共4页Zhejiang Medical Journal

摘　　要：目的分析甲状腺微小乳头状癌(papillary thyroid micorcarcinoma,PTMC)中淋巴结转移的临床特征,并对其影响因素进行多因素分析。方法收集2007年1月至2009年12月488例经术后病理证实为PTMC患者的临床资料以及淋巴结转移情况,分析PTMC临床病理特征、肿瘤位置与淋巴结转移相关性,并采用logistic回归法对淋巴结转移的影响因素进行多因素分析。结果在488例经术后病理证实为PTMC患者中,132例(27.0%)发生淋巴结转移,均未发现远处转移。Ⅱ、Ⅲ、Ⅳ、Ⅴ区淋巴结转移率为11.4%,低于Ⅵ区淋巴结转移率16.0%(P<0.01)。腺外侵犯组淋巴结转移率明显高于无腺外侵犯组(x^2=75.892,P<0.01)。多因素logistic回归分析结果显示腺体外累犯和肿瘤位置为影响淋巴结转移的独立的影响因素。结论淋巴结转移是肿瘤分期的重要组成,腺体外累犯和肿瘤位置为影响淋巴结转移的独立的影响因素,淋巴结转移的特征对于PTMC的治疗具有重要的参考价值。Objective To analyze the clinical features of lymph node metastasis in thyroid papillary microcarcinoma and its related factors. Methods Clinical and pathological data of 488 patients with thyroid papillary microcarcinoma admitted from January 2007 to December 2009 were retrospectively analyzed, including 73 males and 415 females with a mean age of 45.1 ± 9.4. Statistical software SPSS16.0, multivariate Logistic regression analysis were applied for data analysis. Results A- mong 488 cases lymph node metastasis was confirmed by postoperative pathological examination in 132 cases（27.0%）. The dis- tant metastases were not found. The lymph node metastatic rate in II, III, IV, V areas （11.4%） was lower than that in area VI（ 16.0%, P = 0.001）. The lymph node metastatic rate in extrothyroid group was significantly higher than that in non-extrothyroid group （86.1% vs. 22.3%, X2=75.892, P〈O.01）. Multivariate logistic regression analysis showed extrothyroid and tumor locations were in- dependent risk factors of lymph node metastasis. Conclusion The characteristics of lymph node metastasis in papillary thyroid microcarcinoma are of value in the treatment. Lymph node metastasis is an important composition for tumor staging, the extrothy- roid and tumor locations are independent risk factors of lymph node metastasis.

关 键 词：甲状腺微小癌 淋巴结 转移 

分 类 号：R736.1[医药卫生—肿瘤]