甲状腺微小乳头状癌临床病理特征及中央区淋巴结转移危险因素分析  

Clinicopathological characteristics of papillary thyroid microcarcinoma and risk factors for central lymph node metastasis

作　　者：吴艳乐 孙锦明[1] 张进军[1] 崔秋霞[1] 郑伟红[1] 李兴睿[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院甲状腺乳腺外科,武汉430030

出　　处：《中华耳鼻咽喉头颈外科杂志》2017年第6期426-429,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的 探讨甲状腺微小乳头状癌（papillary thyroid microcarcinoma,PTMC）患者的临床病理特征及中央区淋巴结转移的危险因素.方法 回顾性分析2004年1月至2015年12月,华中科技大学同济医学院附属同济医院首诊并且病例资料完整的900例PTMC患者的临床病理特征,应用χ2检验及Logistic多因素回归模型分析影响中央区淋巴结转移的危险因素.结果 707例行中央区淋巴清扫术患者的中央区淋巴结转移率为22.9％,单因素分析显示,发病年龄、肿瘤最大直径、合并包膜侵犯、多发病灶、双侧病灶均与PTMC中央区淋巴结转移密切相关（P值均＜0.01）.多因素Logistic分析显示,发病年龄＜45岁、最大肿瘤直径＞5 mm、多发病灶、双侧病灶及合并包膜侵犯均是PTMC中央区淋巴结转移的独立危险因素（P值均＜0.05）.结论 具备发病年龄＜45岁、最大肿瘤直径＞5 mm、多发病灶、双侧病灶及合并包膜侵犯等特征的患者中央区淋巴结转移的可能性较高,建议积极行预防性中央区淋巴清扫术.Objective To analyze the clinicopathological characteristics of papillary thyroid microcarcinoma （PTMC） and risk factors for central lymph node metastasis （CLNM） in PTMC.Methods The data of 900 patients with PTMC initially treated in our hospital from January 2004 to December 2015 were retrospectively analyzed.Chi-square test and Logistic regression analysis were performed to determine the risk factors for CLNM.Results CLNM affected 162 （22.9%） of 707 patients treated with central lymph node dissection.Age,maximum tumor size,multifocality,bilaterality,and extracapsular spread （ECS） were significantly correlated with CLNM （all P 〈 0.01）.Age 〈 45 years,maximum tumor size 〉 5 mm,multifocality,bilaterality,and extracapsular spread were independently correlated with CLNM.Conclusion A prophylactic central lymph node dissection should be considered in PTMC patients with age 〈45 years,maximum tumor size 〉 5 rmm,multifocality,bilaterality,and extracapsular spread.

关 键 词：甲状腺肿瘤 癌 乳头状 病理学 临床 淋巴转移 危险因素 

分 类 号：R736.1[医药卫生—肿瘤]