甲状腺微小乳头状癌病理亚型相关临床病理特点分析  

Variant-related clinicopathological features in papillary thyroid carcinoma： an analysis of 600 cases

作　　者：只璟泰 郑向前[1] 高明[1] 

机构地区：[1]天津医科大学肿瘤医院甲状腺颈部肿瘤科,国家肿瘤临床医学研究中心,天津市“肿瘤防治”重点实验室.天津市恶性肿瘤临床医学研究中心,300060

出　　处：《中华普通外科杂志》2017年第3期194-197,共4页Chinese Journal of General Surgery

基　　金：国家自然科学基金资助项目（81472580,81272282,81402392）

摘　　要：目的探讨甲状腺微小乳头状癌亚型间临床病理特点上的差异。方法回顾性分析2015年7—12月于天津医科大学附属肿瘤医院收治的600例甲状腺微小乳头状癌患者的临床病理资料，采用Х^2检验比较常见三种亚型分组间的临床病理特点差异，多因素Logistic回归模型分析影响颈部淋巴结转移的独立预测因素。结果经典亚型（43．0％）、滤泡亚型（46．7％）以及包膜内亚型（7．7％）占全部病例的97．3％，滤泡亚型肿瘤直径最大，包膜内亚型钙化率高，无腺外微浸润。淋巴结转移率经典亚型〉滤泡亚型〉包膜内亚型。多因素Logistic回归模型分析发现男性、年龄〈45岁、癌灶钙化、腺外微浸润以及多灶性等是影响颈部淋巴结转移的独立危险因素。结论甲状腺微小乳头状癌中滤泡亚型最为常见。其侵袭性远低于经典亚型。男性、年龄〈45岁、癌灶钙化、腺外微浸润以及多灶性等是影响甲状腺微小乳头状癌颈部淋巴结转移的独立危险因素。Objective To investigate the distinct clinicopathological characteristics among different variants of papillary thyroid microcarcinoma（PTMC）. Methods The clinicopathological data of 600 PTMC patients treated in Tianjin Medical University Cancer Hospital from July 2015 to December 2015 were analyzed retrospectively. Chi-square test was used to compare the distinct clinicopathological features among different variants and multivariate Logistic regression analysis was performed for independent predictors for lymph node metastasis （LNM）. Results Conventional variant （43.0%）, follicular variant （46. 7% ）, and encapsulated variant （7.7%）, accounted for 97.3% of all cases. Follicular variant had the largest tumor size and encapsulated variant had highest rate of calcification and no extrathyroidal extension. The incidence of LNM was the highest in conventional variant followed by follicular variant and then by encapsulated variant. Maleness, age 〈 45, calcification, minimal extrathyroidal extension and muhifocality were independent risk predictors for LNM. Conclusions Follicular variant are the most common in PTMC, whose aggressiveness is far below conventional variant PTMC patients. Independent risk predictors for cervical LNM were maleness, age 〈 45, tumor calcification, minimal extrathyroidal extension and multifocality.

关 键 词：甲状腺肿瘤 癌 乳头状 淋巴结转移 

分 类 号：R736.1[医药卫生—肿瘤]