甲状腺乳头状癌(cN1b)Ⅶ区淋巴结转移危险因素及规律分析  

Risk Factors Analysis for LevelⅦ Lymph Node Metastasis in Papillary Thyroid Carcinoma(cN_(1b))

作　　者：曹永晋[1] 蔡伟华[1] 郑敏[2] 王宗财[1] CAO Yongjin;CAI Weihua;ZHENG Min;WANG Zongcai(Department of Thyroid and Breast Surgery,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China;Department of Chemotherapy,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350005,China)

机构地区：[1]福建医科大学附属第一医院甲状腺乳腺科,福州350005 [2]福建医科大学附属第一医院化疗科,福州350005

出　　处：《福建医科大学学报》2018年第1期33-37,共5页Journal of Fujian Medical University

基　　金：国家临床重点专科建设项目(国卫办医函2013544号);福建省自然科学基金面上项目(2017J11089)

摘　　要：目的探讨甲状腺乳头状癌(cN_(1b))颈部Ⅶ区淋巴结转移的危险因素及转移规律。方法回顾性分析初治的134例甲状腺乳头状癌(cN_(1b))行Ⅱ~Ⅶ区的功能性颈淋巴结清扫的患者,通过χ2检验、多因素Logistic回归分析,比较颈部Ⅶ区淋巴结转移与临床病理因素的相关性。结果颈部Ⅶ区淋巴结转移率为53%。单因素分析显示,肿瘤T分期(P<0.001,χ2=31.897)、Ⅵ区淋巴结转移(P<0.001,χ~2=17.743)、颈侧区淋巴结转移(P=0.032,χ~2=4.773)与Ⅶ区淋巴结转移相关,差别具有统计学意义;多因素分析显示,肿瘤T分期(P=0.001)和Ⅵ区淋巴结转移(P=0.018)是影响颈部Ⅶ区淋巴结转移的独立危险因素。结论甲状腺乳头状癌(cN_(1b))患者有较高的Ⅶ区淋巴结转移率,若存在危险因素建议行Ⅶ区淋巴结清扫术。Objective This study was to analyze the risk factors of levelⅦlymph node metastasis for patients with papillary thyroid carcinoma(PTC)(cN 1b). Methods 134 cases of papillary thyroid carcinoma(cN1b)who underwent levelⅡ-Ⅶlymph node dissection were analyzed retrospectively. Clinical and pathologic data were collected from patients who were first diagnosed as papillary thyroid carcinoma. Chi-square test and multivariate logistic regression analysis were used to identify the risk factors of the levelⅦlymph node metastasis. Results TheⅦlymph node metastasis rate of PTC patients was 53%. Univariate analysis indicated that tumor T staging(P<0.001,χ2=31.897),levelⅥlymph node metastasis(P<0.001,χ2=17.743),and lateral lymph node metastasis(P=0.032,χ2=4.773)were significantly correlated with levelⅦlymph node metastasis. Multivariate logistic regression analysis indicated that tumor T staging(P=0.001)and levelⅥlymph node metastasis(P=0.018)independently correlated with levelⅦlymph node metastasis. Conclusion The(cN1b)PTC has a high rate of pathological lymph node metastasis,It is important to conduct the levelⅦlymph node dissection for the PTC(cN1b)patients with the risk factors.

关 键 词：癌 乳头状 甲状腺肿瘤 淋巴结 危险因素 

分 类 号：R322.25[医药卫生—人体解剖和组织胚胎学] R730.261[医药卫生—基础医学]