多灶性甲状腺微小乳头状癌中央区淋巴结转移影响因素的研究  

Clinical and Ultrasounic Analysis of Central Lymph Node Metastasis Risk Factors in Patients with Multiple Papillary Thyroid Microcarcinoma

作　　者：梁振威 邵玉红[1] 陈蕾[1] 刘晶华[1] 陈路增[1] Liang Zhenwei;Shao Yuhong;Chen Lei;Liu Jinghua;Chen Luzeng(Department of Ultrasound,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院超声医学科,北京市100034

出　　处：《中国超声医学杂志》2021年第9期971-973,共3页Chinese Journal of Ultrasound in Medicine

基　　金：北京大学第一医院科研种子基金(No.2021SF31)。

摘　　要：目的探讨多灶性甲状腺微小癌中央区淋巴结转移(CLNM)的影响因素。方法回顾性分析甲状腺多灶性微小乳头状癌病例,分析年龄、性别、有无桥本甲状腺炎、术前超声检查结节数目、单双叶分布、被膜侵犯、BRAF基因突变、结节长径之和(TTD)、最大结节与所有结节长径和比值(TDR)对有无CLNM的差异。结果入组144例多灶性PTMC,CLNM率28.5%(41/144);结节单双叶分布、性别、伴有桥本甲状腺炎、TTD、TDR等有CLNM组和无CLNM组均无统计学差异(P>0.05);BRAF突变组、<45岁组、≥3个结节组、被膜侵犯组CLNM率较高(35.2%∶17.0%,42.9%∶21.1%,63.2%∶23.2%,57.9%∶17.9%,P<0.05)。多因素分析显示超声显示病灶数目≥3个、<45岁、被膜侵犯是多灶性PTMC有CLNM的独立危险因素(P<0.05)。结论多灶性PTMC病灶数目≥3个、<45岁、被膜侵犯是中央区淋巴结转移的独立危险因素。Objective To identify factors associated with the central lymph node metastasis(CLNM)in multifocal thyroid microcarcinoma(PTMC).Methods The clinic and ultrasound data of 144 multiple PTMC patients were enrolled.Univariate and multivariate analysis were used to identify risk factors associated with CLNM.Results The frequency of CLNM was approximately 28.5%(41/144)in multifocal PTMC.There was no significant difference in the incidence of CLNM in distribution of unilateral or bilateral,age,gender,coexistent with Hashimoto thyroiditis、TTD、TDR(P<0.05).The incidence of CLNM in the groups of BRAF mutation,<45,≥3 nodules and ETE were higher than the groups of none BRAF mutation,≥45,2 nodule and no ETE respectively(35.2%vs 17.0%,42.9%vs 21.1%,63.2%vs 23.2%and 57.9%vs 17.9%,P<0.05).Multivariate logistic regression analysis showed that<45,ETE and the number of tumor foci(≥3)were the independent risk factors of CLNM(P<0.05).Conclusions<45,ETE and the number of tumor foci of PTMC(≥3)were the independent risk factors for central lymph node metastasis.

关 键 词：甲状腺微小乳头状癌 多灶 中央区淋巴结转移 

分 类 号：R445.1[医药卫生—影像医学与核医学] R736.1[医药卫生—诊断学]