双侧甲状腺微小乳头状癌临床特点及手术方式的探讨  

Research of the Clinical Character and Reasonable Operation of Bilateral Papillary Thyroid Microcarcinoma

作　　者：王昭君[1,2] 许践刚[1,2] 张宪波[1,2] 赵挺[1,2] 张筱骅[3] 

机构地区：[1]温州医科大学定理临床学院 [2]温州市中心医院肿瘤外科,温州325000 [3]温州医科大学附属第一医院肿瘤外科

出　　处：《数理医药学杂志》2016年第10期1430-1432,共3页Journal of Mathematical Medicine

摘　　要：目的:探讨双侧甲状腺微小乳头状癌(PTMC)的临床特点及手术方式。方法:回顾性分析接受手术治疗的112例双侧甲状腺微小乳头状癌患者的临床病理资料,采用单因素和logistic多因素分析方法分析双侧中央区淋巴结(VI区)转移的危险因素。结果:单因素分析结果显示,年龄、性别和有无双侧多灶癌是双侧中央区淋巴结转移的危险因素(P<0.05);多因素分析结果显示年龄小于45岁、双侧多灶癌是双侧中央区淋巴结转移(CLNM)的独立影响因素(P<0.05或0.01)。本组患者无发生永久性喉返神经损伤和甲状旁腺功能低下,无出现术后出血。结论:双侧甲状腺微小乳头状癌初次手术应宜甲状腺全切,对年龄小于45岁、双侧多灶癌应重视中央组淋巴结清扫。Objective：To research the clinical character and reasonable operation of bilateral papillary thyroid microcarcinoma（PTMC）.Methods：The clinical features of 112 postoperative bilateral PTMC patients were retrospectively analyzed,to analyze the risk factors of bilateral central lymph node metastasis by univariate and multivariate Logistic regression analysis method.Results：Univariate analysis showed that age,gender and bilateral multifocal carcinoma were the risk factors of metastasis（P〈0.05）;Multivariate logistic regression analysis showed that age less than 45 years old and bilateral multifocal carcinoma were the independent risk factors of central bilateral lymph node metastasis（CLND）（P〈0.05 or〈 0.01）.There was no case of permanent hypoparathyroidism,recurrent laryngeal nerve,and bleeding after operation.Conclusion：Total thyroidectomy should be performed in all patients with papillary thyroid papillary carcinoma for the first time,and the central neck dissection is necessary,especially in the patients less than 45 years old and with bilateral multifocal carcinoma.

关 键 词：甲状腺肿瘤 乳头状微小癌 淋巴结转移 

分 类 号：R736.1[医药卫生—肿瘤]