甲状腺癌喉返神经入喉处淋巴结转移的临床病理因素相关性分析  

Correlation analysis of clinicopathological factors of lymph node metastasis of recurrent laryngeal nerve in thyroid carcinoma

作　　者：杨晓晴[1] 许洁[2] 郑桂彬[1] 王正寨 林溪源 郑海涛[1] Yang Xiaoqing;Xu Jie;Zheng Guibin;Wang Zhengzhai;Lin Xiyuan;Zheng Haitao(Department of Thyroid Surgery,Yantai Yuhuangding Hospital of Medical College of Qingdao University,Yantai Shandong Province 264000,China;Department of Nutrition,Yantai Yuhuangding Hospital of Medical College of Qingdao University,Yantai Shandong Province 264000,China)

机构地区：[1]青岛大学附属烟台毓璜顶医院甲状腺外科,山东烟台264000 [2]青岛大学附属烟台毓璜顶医院临床营养科,山东烟台264000

出　　处：《中华普外科手术学杂志（电子版）》2022年第6期692-695,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：山东省医药卫生科技发展计划项目(2018WS031)。

摘　　要：目的:探讨甲状腺癌(TC)中喉返神经入喉处区域(RLNIZ)淋巴结转移的相关临床病理因素,同时说明其在中央区淋巴结清扫的临床意义。方法:回顾性分析2018年8月至2020年10月1240例甲状腺乳头状癌(PTC)患者的临床资料,其中经病理诊断确认370例RLNIZ淋巴结,根据有无转移分为两组,RLNIZ淋巴结转移组(n=110)和RLNIZ淋巴结未转移组(n=260)。数据分析应用SPSS 23.0软件,计量资料采用(x±s)表示,计数资料采用[n(%)]表示,RLNIZ淋巴结转移与各临床病理因素之间的关系采用单因素χ^(2)检验、多因素Logistic回归分析。P<0.05为检验标准。结果:RLNIZ淋巴结检出率为29.8%(370/1240),其中RLNIZ转移组占29.7%(110/370),RLNIZ未转移组占70.3%(260/370),平均检出淋巴结数目为(1.45±0.9)枚。BRAF600VE突变(P=0.018)、合并桥本(P=0.049)、喉前(P=0.017)及侧颈部(P<0.001)淋巴结转移是RLNIZ转移的独立危险因素。结论:甲状腺癌中央区清扫要留意RLNIZ淋巴结清扫,避免遗漏致后期复发。ObjectiveTo investigate the clinicopathological factors associated with lymph node metastasis in the recurrent laryngeal nerve entry area(RLNIZ)of thyroid cancer(TC),and to explain its clinical significance in central lymph node dissection.MethodsThe clinical data of 1,240 patients with papilary thyroid carcinoma(PTC)from August 2018 to October 2020 were retrospectively analyzed.Among them,370 patients with RLNIZ lymph nodes were confirmed by pathological diagnosis.According to the presence or absence of metastasis,they were divided into two groups:RLNIZ lymph node metastasis group(n=110)and RLNIZ lymph node non-metastasis group(n=260).The measurement data were expressed as(x±s),and the count data were expressed as[n(%)].The relationship between RLNIZ lymph node metastasis and clinicopathological factors was analyzed by univariateχ^(2)test and multivariate Logistic regression analysis,with P<0.05 as the test standard.ResultsThe detection rate of RLNIZ lymph nodes was 29.8%(370/1240),including 29.7%(110/370)in RLNIZ metastasis group and 70.3%(260/370)in RLNIZ non-metastasis group.The average number of detected lymph nodes was(1.45±0.9).BRAFovE mutation(P=0.018),Hashimoto(P=0.049),prelaryngeal(P=0.017)and lateral neck(P<0.001)lymph node metastasis were independent risk factors for RLNIZ metastasis.ConclusionIn central dissection of thyroid cancer,attention should be paid to RLNIZ lymph node dissection to avoid late recurrence caused by omission.

关 键 词：甲状腺肿瘤 喉返神经人喉处区域 中央区淋巴结 淋巴结转移 

分 类 号：R736.1[医药卫生—肿瘤]