甲状腺乳头状癌淋巴结转移数目与临床病理特征的相关性分析  

Correlation between the number of metastaic lymph nodes and clinicopathological characteristics in papillary thyroid carcinoma

作　　者：詹玲 陈创[1] 孙圣荣[1] ZHAN Ling;CHEN Chuang;SUN Shengrong(Department of Breast and Thyroid Surgery Renmin Hospital of Wuhan University Wuhan 430060,China)

机构地区：[1]武汉大学人民医院乳腺甲状腺外科,武汉430060

出　　处：《中华实用诊断与治疗杂志》2020年第12期1206-1208,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家自然科学基金青年科学基金(81302314);湖北省卫生健康委员会科研项目(WJ2019M188);湖北省技术创新专项(重大项目)(2019AEA170)。

摘　　要：目的探讨淋巴结转移数目与甲状腺乳头状癌(papillary thyroid carcinoma,PTC)患者临床病理特征的关系及意义。方法经手术治疗的PTC伴颈淋巴结转移患者872例,依据淋巴结转移数目分为转移淋巴结≤5枚组652例和转移淋巴结>5枚组220例,比较2组临床病理学特征;采用多因素logistic回归分析PTC患者转移淋巴结>5枚的影响因素。结果转移淋巴结>5枚组年龄<55岁(88.6%)、肿瘤直径>2.0 cm(22.7%)、非微小癌(80.0%)、双侧癌(49.1%)、多癌灶(54.1%)、腺外侵犯(92.3%)比率高于转移淋巴结≤5枚组(81.6%、10.7%、62.9%、29.6%、36.7%、74.4%)(P<0.05),TNM分期Ⅱ期比率(11.4%)低于转移淋巴结≤5枚组(18.6%)(P<0.05)。年龄<55岁(OR=1.990,95%CI:1.231~3.218,P=0.005)、肿瘤直径>2.0 cm(OR=1.756,95%CI:1.138~2.709,P=0.011)、非微小癌(OR=1.758,95%CI:1.184~2.609,P=0.005)、双侧性(OR=1.780,95%CI:1.174~2.699,P=0.007)、腺外侵犯(OR=3.159,95%CI:1.836~5.436,P<0.001)是PTC患者转移淋巴结>5枚的独立危险因素。结论年龄<55岁、肿瘤直径>2.0 cm、非微小癌、双侧性、腺外侵犯的PTC患者更易出现淋巴结转移。Objective To investigate the relationship between the number of metastatic lymph nodes(NMLNs)and the clinicopathological characteristics of papillary thyroid carcinoma(PTC)and its significance.Methods Totally 872 PTC patients with cervical lymph node metastasis after surgery were divided into 652 patients with≤5 NMLNs(≤5 NMLNs group)and 220 patients with>5 NMLNs(>5 NMLNs group).The clinicopathological characteristics were compared between two groups.The influencing factors of>5 NMLNs were analyzed by multivariate logistic regression model.Results The percentages of age<55 years(88.6%),tumor diameter>2.0 cm(22.7%),non-papillary thyroid microcarcinoma(80.0%),bilaterality(49.1%),multifocality(54.1%),and extrathyroidal extension(92.3%)in>5 NMLNs group were significantly higher than those in≤5 NMLNs group(81.6%,10.7%,62.9%,29.6%,36.7%,74.4%)(P<0.05),while the percentage of TNM stageⅡwas lower in>5 NMLNs group(11.4%)than that in≤5 NMLNs group(18.6%)(P<0.05).The age<55 years(OR=1.990,95%CI:1.231-3.218,P=0.005),tumor diameter>2.0 cm(OR=1.756,95%CI:1.138-2.709,P=0.011),non-papillary thyroid microcarcinoma(OR=1.758,95%CI:1.184-2.609,P=0.005),bilaterality(OR=1.780,95%CI:1.174-2.699,P=0.007)and extrathyroidal extension(OR=3.159,95%CI:1.836-5.436,P<0.001)were the independent risk factors for>5 NMLNs.Conclusion Lymph node metastasis usually occurs in patients with age<55 years,tumor diameter>2.0 cm,non-papillary thyroid microcarcinoma,bilaterality and extrathyroidal extension.

关 键 词：甲状腺乳头状癌 淋巴结转移 淋巴结转移数目 临床病理特征 

分 类 号：R736.1[医药卫生—肿瘤]