甲状腺微小乳头状癌中央区淋巴结转移危险因素分析  

Analysis of the risk factors of central compartment lymph node metastasis in papillary thyroid microcarcinoma

作　　者：王斌[1] 孙海清[2] 陈波[2] 吕斌[2] 李鲁传[2] 张强波[2] 曾庆东[2] 

机构地区：[1]临朐县人民医院普通外科,山东临朐262600 [2]山东大学齐鲁医院普通外科,山东济南250014

出　　处：《中华肿瘤防治杂志》2015年第16期1318-1320,共3页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的探讨甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)患者中央区淋巴结转移的相关危险因素,为选择性地进行中央区淋巴结清除术提供一定的临床依据。方法选择2011-10-01-2013-01-30山东大学齐鲁医院手术治疗的150例PTMC患者(不包含因复发手术的病例)的临床资料,回顾性分析PTMC患者中央区淋巴结转移的独立危险因素。结果甲状腺乳头状微小癌中央区总转移率为35.3%(53/150)。单因素分析显示,肿瘤大小、有无被膜侵犯和临床分期cN1者与中央区淋巴结转移密切相关,P<0.05;多因素分析显示,肿瘤大小(OR=2.466,P=0.010)、被膜侵犯(OR=1.632,P=0.005)、临床分期(OR=2.070,P=0.001)同样为中央区淋巴结转移的独立危险因素;3个独立危险因素均不具备者的中央区淋巴结转移率(16.3%,7/43)明显低于具备任一危险因素者(43.0%,45/107),P=0.002。结论 PTMC患者肿瘤大小、肿瘤侵犯被膜、临床分期cN1是中央区淋巴结转移独立危险因素,具备相关危险因素患者有必要常规行中央区淋巴结清除。OBJECTIVE To analyze the risk factors for central lymph node metastasis （CLNM） of papillary thyroid microearcinoma（PTMC）. METHODS Clinical data of 150 patients with PTMC, who had undergone surgical treatment between October 2011 and January 2013 in Qilu Hospital of Shandong University were retrospected. Risk factors for CLNM were identified by univariate analysis and multivariate analysis, which could provide the basis for elective perform- ance of central lymph node dissection（CLND）. RESULTS The rate of central compartment lymph node metastasis in pa- pillary thyroid microcarcinoma was 35.3 % （53/150）. Univariate analysis showed that CLNM was correlated with tumor size〉5 mm, extrathyroidal extension and clinic stage of cN1; Multivariate analysis showed that, tumor size 〉5 mm （OR=2. 466,P=0. 010）, extrathyroidal extension （OR=1. 632, P=0. 005） and clinic stage （OR=2. 070, P=0. 001） were independent risk factors for CLNM. The metastasis rate （16.3G ,7/43） in patients without any risk factor was lower than that（43.0% ,45/107） with some （P=0. 002）. CONCLUSION Patients presenting tumor size 〉5 mm, extrathy roidal extension and clinic stage of cN1 may have an increased risk of central lymph node metastasis, and it is necessary to perform central lymph node dissection for the patient who has one of the risks.

关 键 词：甲状腺微小乳头状癌 淋巴结转移 中央区淋巴结清除 回顾性研究 危险因素 

分 类 号：R736.1[医药卫生—肿瘤]