甲状腺乳头状癌多发淋巴结转移的危险因素分析及其对术后甲状旁腺功能的影响  

The Risk Factor Analysis for High Volume Lymph Node Metastasis in Papillary Thyroid Carcinoma and Its Affection to Postoperative Parathyroid Function

作　　者：莎仁高娃 刘跃武[2] 张芳[3] SHAREN Gaowa;LIU Yue-wu;ZHANG Fang(Department of Health Management,Chinese Academy of Medical Sciences&Chinese Union Medical College,Beijing 100730,China;Department of General Surger,Chinese Academy of Medical Sciences&Chinese Union Medical College,Beijing 100730,China;Department of Clinical Laboratory,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Chinese Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院健康医学部,北京100730 [2]中国医学科学院北京协和医学院北京协和医院基本外科,北京100730 [3]中国医学科学院北京协和医学院北京协和医院检验科,北京100730

出　　处：《标记免疫分析与临床》2019年第10期1621-1623,1667,共4页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨甲状腺乳头状癌多发淋巴结转移(>5个)的相关危险因素及其对术后甲状旁腺功能的影响。方法回顾分析2011年至2015年于北京协和医院基本外科行手术治疗并经病理学确诊甲状腺癌患者340例,分为淋巴结转移5个以上组(A组)及无淋巴结转移组(B组),分析淋巴结转移的危险因素以及术后对甲状旁腺功能的影响。结果①甲状腺癌淋巴结转移5个以上的男性患者(67.19%)多于女性患者(31.13%),差异具有统计学意义;②A组患者平均年龄明显低于B组,且≤30岁的患者淋巴结转移比例最高达73.2%;③术后两组患者均进行钙、磷、甲状旁腺素检查,两组比较结果显示,两组血钙浓度无显著性差异,但A组血磷水平高于B组,同时A组甲状旁腺素低于B组,差异具有统计学意义。结论男性和年龄≤40岁为甲状腺癌淋巴结转移的危险因素;淋巴结转移增多将增加术后甲状旁腺功能的损害,因此,男性和年轻患者应予以相应的积极治疗。Objective To investigate the risk factors for high volume lymph node metastasis(>5 metastatic lymph nodes)in papillary thyroid carcinoma.Methods The medical records of 340 thyroid cancer patients who underwent thyroidectomy with central level lymph node dissection in Department of General Surgery,Peking Union Medical College Hospital from 2011 to 2015 were retrospectively analyzed.The patients were divided into A group(>5 metastatic lymph nodes)and B group(non-metastatic lymph node).The analysis was performed to identify risk factors for high volume lymph node metastasis and the influence for parathyroid function.Results①Male patients with high volume lymph node metastasis(>5)(67.19%)were more than the female patients(31.13%)with significant differences.②The average age of patients in group A was significantly lower than that in group B.③Postoperative examinations of calcium,phosphorus and PTH were performed in both groups.There was no significant difference in the blood calcium concentration.The blood phosphorus concentration of group A was significantly higher than that of group B,and the parathyroid hormone of group A was significantly lower than that of group B.Conclusion Male and young age(<40 years old)are risk factors for high volume lymph node metastasis.The postoperative parathyroid function more likely appear with more LN metastasis,therefore,the operation should be more active in patients who are male or less than 40 years old.

关 键 词：甲状腺癌 淋巴结转移 危险因素 

分 类 号：R73[医药卫生—肿瘤]