甲状腺乳头状癌淋巴结跳跃转移规律分析  

Analysis of lymph node jump metastasis in papillary thyroid carcinoma

作　　者：乔雷 董朝[1] 张楠[1] 马斌林[1] QIAO Lei;DONG Chao;ZHANG Nan;MA Binlin(Department of Breast and Head-Neck Surgical Oncology, the Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, 830011, China)

机构地区：[1]新疆医科大学附属肿瘤医院乳腺头颈外科,乌鲁木齐830011

出　　处：《临床耳鼻咽喉头颈外科杂志》2018年第7期522-526,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：新疆维吾尔自治区自然科学基金(No:2017D01C410)

摘　　要：目的:探讨甲状腺乳头状癌(PTC)侧颈部淋巴结转移及跳跃转移规律。方法:将301例PTC患者根据病理结果分为侧颈部淋巴结阳性组和阴性组;侧颈部淋巴结跳跃转移组和阴性组。采用χ2检验及Logistic回归分析侧颈部淋巴结状态与临床病理之间的关系。结果:癌灶>2cm、腺叶多发、多灶、突破被膜、B超血流信号、钙化点、合并结节性甲状腺肿、癌组织内沙砾体、主要癌灶位于腺体峡部及上极、气管前/旁淋巴结阳性与侧颈部淋巴结转移具有相关性(P<0.05);癌灶>2cm、癌灶总直径>2cm、B超可见钙化点、癌组织内沙砾体、主要癌灶位于腺叶上极、中极与淋巴结跳跃转移具有相关性(P<0.05)。结论:腺叶多发、多灶、癌组织内沙砾体、上极和中极癌灶是淋巴结跳跃转移的独立危险因素。Objective：To summarize the metastatic feature of lateral neck lymph node metastasis in papillary thyroid carcinoma.Method：Clinical and pathological data were collected from 301 patients who were first diagnosed as PTC in our hospital.These patients were divided into positive and negative status of lateral cervical lymph nodes and lymph node jump metastasis.Chi-square test and Logistic regression analysis were used to evaluate the relationship between lateral cervical lymph node status and clinicopathology.Result：Tumor size over 2 cm,Unilateral thyroid gland contains multiple foci,multiple foci,capsular invasion,ultrasound feature of PTC,the main foci located in the isthmus and the pole of gland,trachea/parathyroid lymph nodes positive were associated with the lymph node jump metastasis in papillary thyroid（P〈0.05）.Conclusion：Multiple foci in single gland,multifocal foci,calcification and the primary tumor involving the superior pole and middle of the thyroid gland are independent influencing factors for skip lateral lymph node metastasis in PTC（P〈0.05）.

关 键 词：甲状腺肿瘤 侧颈部淋巴结转移 淋巴结跳跃转移 

分 类 号：R736.1[医药卫生—肿瘤]