甲状腺乳头状癌颈侧区淋巴结转移危险因素分析  

Analysis of Risk Factors for Cervical Lymph Node Metastasis of Papillary Thyroid Carcinoma

作　　者：方芳[1] 陈晓林[1] 陈剑平[1] 汪向明[2] 殷照才[1] 吴正清[1] 于昌盛[1] 梅振宇[1] FANG Fang;CHEN Xiao-lin;CHEN Jian-ping;WANG Xiang-ming;YIN Zhao-cai;WU Zheng-qing;YU Chang-sheng;MEI Zhen-yu(Department of Thyroid and Breast Surgery,The Affiliated Yijishan Hospital of Wannan Medical College,Wuhu 241001,China;Department of Pathology,The Affiliated Yijishan Hospital of Wannan Medical College,Wuhu 241001,China)

机构地区：[1]皖南医学院弋矶山医院甲状腺乳腺外科,安徽芜湖241001 [2]皖南医学院弋矶山医院病理科,安徽芜湖241001

出　　处：《中山大学学报（医学版）》2019年第4期571-577,共7页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：安徽省卫计委科研计划项目(2016QK055)

摘　　要：【目的】探究甲状腺乳头状癌(PTC)颈侧区淋巴结转移的临床特征。【方法】回顾性分析皖南医学院附属弋矶山医院2011年6月1日至2018年5月30日收治的PTC患者临床资料。【结果】本研究共纳入241例病例。术后常规病理证实颈侧区淋巴结转移率73.44%(177/241)。与颈侧区淋巴结无转移的PTC患者相比,伴颈侧区淋巴结转移的PTC患者年龄偏小,多为女性,癌肿直径较大,颈中央区淋巴结转移数目较多,超声及CT检查积分更高。而BMI指数、桥本氏甲状腺炎病史及甲亢病史对PTC颈侧区淋巴结转移率无显著性影响。【结论】患者为年轻女性、超声及CT检查积分≥4,并术中病理提示癌灶直径≥2.0cm,中央区淋巴结转移数目大于等于5枚时,应高度怀疑PTC伴颈侧区淋巴结转移,建议行颈侧区淋巴结清扫。【Objective】To investigate the clinical features of cervical lymph node metastasis in papillary thyroid carcinoma(PTC).【Methods】The clinical data of patients suffering from papillary thyroid carcinoma admitted to the Affiliated Hospital of Wannan Medical College from June 1,2011 to May 30,2018 were retrospectively analyzed.【Results】A total of 241 cases were included in the study.Postoperative routine cases confirmed the cervical lymph node metastasis rate was 73.44%(177/241).Compared with PTC patients with no metastases in the cervical lymph nodes, PTC patients with cervical lymph node metastasis were younger,mostly female,with larger diameters of cancer,more cervical lymph node metastases,and higher scores of ultrasound and CT.The BMI index,history of Hashimoto′s thyroiditis or hyperthyroidism had no significant effect on the rate of lymph node metastasis in the PTC neck.【Conclusion】For young women patients,with ultrasound and CT scores ≥ 4,and whose intraoperative pathology suggest that the diameter of the tumor is ≥ 2.0 cm,and the number of lymph node metastases in the central region is greater than or equal to 5,it should be highly suspected that the patients are suffering from PTC with cervical lymph node metastasis,and need cervical lymph node dissection.

关 键 词：甲状腺乳头状癌 颈侧区淋巴结 淋巴结转移 

分 类 号：R736.1[医药卫生—肿瘤]