205例甲状腺微小乳头状癌与中央区淋巴结转移的相关性分析  

Correlation between Thyroid Micropapillary Carcinoma and Central Lymph Node Metastasis:A Clinical Analysis of 205 Cases

作　　者：相开放 刘春萍[2] 赵顺林 张长芬 XIANG Kaifang;LIU Chunping;ZHAO Shunlin;ZHANG Changfen(Department of Thyroid and Breast Surgery,Union Jiangnan Hospital,Huazhong University of Science and Technology,Wuhan 430000,China;Department of Breast and Thyroid Surgery,Union Hospital of Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学协和江南医院甲乳外科,武汉430000 [2]华中科技大学附属协和医院乳腺甲状腺外科,武汉430022

出　　处：《宁夏医科大学学报》2021年第4期401-405,共5页Journal of Ningxia Medical University

摘　　要：目的探讨甲状腺微小乳头状癌(PTMC)患者临床病理特征与中央区淋巴结转移相关性。方法回顾性分析2017年1月至2019年3月就诊于华中科技大学协和江南医院甲乳外科的205例PTMC患者的临床病理特征,应用χ2检验和多因素Logistic回归模型分析中央区淋巴结转移的相关影响因素。结果205例PTMC患者中央区淋巴结转移率为39.5%(81例)。单因素分析显示,男性、年龄<55岁、肿瘤直径>5 mm、肿瘤位于甲状腺下极、多灶性、多发癌灶直径之和(total thyroid diameter,TTD)>1 cm、包膜侵犯等均与中央区淋巴结转移有关(P<0.05)。多发灶总直径>1 cm的患者中央区淋巴结转移率与单灶组以及多灶且TTD≤1 cm组比较有统计学意义,需按甲状腺乳头癌(PTC)处理;多因素分析显示,男性患者、年龄<55岁、肿瘤大小、多灶性、包膜侵犯是PTMC患者发生中央区淋巴结转移的影响因素(P均<0.05)。结论具备年龄<55岁、男性、肿瘤直径>5 mm、包膜侵犯、多灶性、TTD>1 cm、包膜侵犯等特征的PTMC患者,较易发生中央区淋巴结转移,建议行预防性中央区淋巴结清扫。Objective To investigate the clinical pathological features of thyroid papillary carcinoma patients with lymph node metastasis in central region.Methods The clinicopathological features of 205 patients of department of thyroid and breast surgery,Union Jiangnan Hospital of Huazhong University of Science and Technology with PTMC from January 2017 to March 2019 were retrospectively analyzed.The risk factors of central lymph node metastasis were analyzed by Chi-square test and multivariate Logistic regression model.Results The metastasis rate of lymph nodes in central region of 205 patients with PTMC was 39.5%(81 cases).Univariate analysis showed that male,age<55 years old,tumor diameter>5 mm,tumor located in the lower pole of the thyroid,multifocal,total thyroid diameter(TTD)>1 cm,capsule invasion were associated with central lymph node metastasis(P<0.05).The metastasis rate of lymph nodes in the central region of patients with multiple focus diameter>1 cm was statistically significant compared with that of single focus group and multi focus group with TTD≤1 cm,which should be treated with PTC.Multivariate analysis showed that male patients,age<55 years old,tumor size,multifocal and capsule invasion were independent influencing factors of lymph node metastasis in the central region of PTMC(P all<0.05).Conclusion PTMC patients with age<55 years old,male,tumor diameter of>5 mm,capsule invasion,TTD>1 cm,multiple lesions,capsule invasion and other characteristics are more likely to have central lymph node metastasis,so preventive central lymph node dissection is recommended.

关 键 词：甲状腺 微小乳头状癌 中央区淋巴结 多发癌灶直径之和 相关性 

分 类 号：R581[医药卫生—内分泌]