甲状腺微小乳头状癌中央区淋巴结转移的临床分析  

Clinical analysis of risk factors of central regional lymphatic metastasis of patients with thyroid papillary microcarcinoma

作　　者：王勇 王玲[2] 

机构地区：[1]湖北省宜城市人民医院普外科,441400 [2]湖北省襄阳市中心医院普外科,441021

出　　处：《中华普外科手术学杂志（电子版）》2016年第5期390-392,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的分析甲状腺微小乳头状癌发生中央区淋巴结转移的危险因素。方法回顾性分析2010年6月至2014年6月期间所收治的50例甲状腺微小乳头状癌患者临床病理资料。应用SPSS21.0统计学软件对本次研究观察所获得的相关数据进行处理,如患者病灶数量比较多,则以最大病灶直径为准并纳入统计范围,用卡方进行检验,多因素则采用Logistic回归加以分析,评估中央区淋巴结转移的危险因素。当P<0.05时视为差异存在统计学意义。结果 50例接受中央区淋巴结清扫术的患者中,≤45岁者中央区淋巴结发生转移的概率达到42.1%,而超过45岁者中央区淋巴结发生转移概率只有25.0%(χ2=15.38);10例男性患者中央区淋巴结发生转移的概率高达60.0%,40例女性中央区淋巴结转移率22.5%(χ2=9.76);肿瘤直径5 mm以内(含5 mm)转移率为22.7%,肿瘤直径超过5 mm者转移率为35.7%(χ2=4.16);以上比较差异均具有统计学意义(P<0.05)。但显示与肿瘤数目无明显相关性(χ2=0.049)。另外,经过Logistic回归分析,结果表明甲状腺微小乳头状癌患者中年龄低于45岁的男性患者,当肿瘤直径>5 mm时发生中央区淋巴结转移的风险较高,是中央区淋巴结转移的主要危险因素。结论甲状腺微小乳头状癌中央区淋巴结转移的阳性率较高,对直径超过5 mm的肿瘤有必要行中央区淋巴结清扫,以提高患者生存质量。Objective To analyze the risk factors of central regional lymphatic metastasis of patients with thyroid papillary microcarcinoma. Methods From June 2010 to June 2014,the clinical data of50 patients with papillary thyroid microcarcinoma were retrospectively analyzed. Statistical analysis were performed by using SPSS 21. 0 software. In present study,if patients with multiple lesions,maximum diameter of lesions was collected and analyzed by using chi square test and logistic regression. Risk factors of central regional lymphatic metastasis of patients with thyroid papillary microcarcinoma were evaluated. A P value of 0. 05 was considered to be significant difference. Results Among 50 patients underwent central lymph node dissection,42. 1% of central regional lymphatic metastasis were observed in patients ≤45 years old,while 25. 0% of central regional lymphatic metastasis in patients ≥45 years old（ χ^2= 15. 38）.60. 0% of central regional lymphatic metastasis were observed in 10 male patients,while 22. 5% of central regional lymphatic metastasis were observed in 40 female patients（ χ^2= 9. 76）. When tumor diameter was less than 5 mm（ including 5 mm）,the was 22. 7%,while 35. 7% of metastasis rate in patients with tumor diameter more than 5 mm（ χ^2= 4. 16）,with statistically significant difference（ P〈0. 05）. However,there was no significant correlation between the number of tumors and metastasis rate（ χ^2= 0. 049）. By using logistic regression analysis,data showed risk factors of central regional lymphatic metastasis included ≤45 years old,male and the tumor diameter 5 mm. Conclusion Central regional lymphatic metastasis is common in patients with thyroid papillary microcarcinoma. When the tumor diameter more than 5mm,central lymph node dissection should be performed to improve the quality of life.

关 键 词：甲状腺肿瘤 乳头状瘤 淋巴转移 淋巴结切除术 

分 类 号：R736.1[医药卫生—肿瘤]