男性甲状腺乳头状癌临床病理特征及颈淋巴结转移危险因素分析  

Analysis of clinicopathological characteristics and risk factors for cervical lymph node metastasis in male papillary thyroid carcinoma

作　　者：季振华[1] 蒋斌[1] 陈卫贤[1] 戴文成[1] JI Zhenhua;JIANG Bin;CHEN Weixian;DAI Wencheng(Department of Head and Neck Surgery,Affiliated Tumor Hospital of Nantong University,Nantong 226000,China)

机构地区：[1]南通大学附属肿瘤医院头颈外科,南通226000

出　　处：《中国眼耳鼻喉科杂志》2023年第4期293-297,共5页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：南通市科学技术局重点项目(MS22021020)。

摘　　要：目的分析男性甲状腺乳头状癌的临床病理特征及其颈淋巴结转移相关危险因素。方法回顾分析我科2017年1月—2021年12月收治的甲状腺乳头状癌患者1117例,均为首次手术。男性219例设为研究组,女性898例设为对照组,比较2组患者的临床病理资料,采用单因素分析和多因素分析统计学方法研究男性甲状腺乳头状癌颈淋巴结转移的危险因素。结果男性甲状腺乳头状癌患者微小癌、合并桥本甲状腺炎的比例低于女性患者,差异有统计学意义(P<0.05,P<0.01);男性甲状腺癌患者T1期比例低于女性患者,T2、T3、T4期比例高于女性,2组患者肿瘤T分期差异有统计学意义(P<0.05);男性甲状腺乳头状癌患者的中央区淋巴结转移率及颈侧区淋巴结转移率均高于女性患者,差异均有统计学意义(P值均<0.01);多因素Logistic回归分析结果显示,肿瘤最大径>1.0 cm为男性甲状腺乳头状癌患者中央区淋巴结转移及颈侧区淋巴结转移的独立危险因素(P<0.01)。结论与女性甲状腺乳头状癌相比,男性甲状腺乳头状癌恶性程度更高,更易出现颈部淋巴结转移,对于肿瘤直径>1.0 cm的男性甲状腺癌患者,要尤为注意颈淋巴结的清扫。Objective To analyze the clinical pathological features of male papillary thyroid carcinoma(PTC)patients and the risk factors of cervical lymph node metastasis.Methods The clinical data of 1117 patients collected in Affiliated Tumor Hospital of Nantong University from January 2017 to December 2021 were retrospectively analyzed.All the patients had the thyroid carcinoma radical resection without any surgical history of the thyroid.A total of 219 male patients were considered as the study group and 898 female patients were the control group.The clinical pathological features of the two groups were compared.The risk factors influencing cervical lymph node metastasis of male PTC patients were analyzed by univariate analysis and multivariate logistic regression.Results Compared to the control group,the proportion of male patients with thyroid micropapillary carcinoma(PTMC)and Hashimoto thyroiditis(HT)was lower.The difference was statistically significant(P<0.05,P<0.01).The proportion of T1 staging in male PTC patients was lower than that in female PTC patients,while the proportion of T2,T3 and T4 staging in male PTC patients was higher than that in female PTC patients.The difference in tumor T staging between the two groups was statistically significant(P<0.05).The incidence of central and lateral lymph node metastasis of male PTC patients was higher than control group.The difference was statistically significant(P<0.01).Multivariate logistic regression showed that the maximum diameter of tumor>1.0 cm was an independent risk factor for central and lateral lymph node metastasis of male PTC patients(P<0.01).Conclusions Compared with female PTC,male PTC seems has a greater malignant behavior.For male PTC patients with tumor diameter>1.0cm,cervical lymph node dissection should be paid special attention.

关 键 词：甲状腺乳头状癌 男性 淋巴结转移 

分 类 号：R762[医药卫生—耳鼻咽喉科]