合并桥本甲状腺炎的甲状腺乳头状癌颈部淋巴结转移的特征分析:文献综述  

Characteristics analysis of cervical lymph node metastasis in papillary thyroid carcinoma coexisting with Hashimoto thyreoiditis:a literatures review

作　　者：段成铖 沈珂羽 肖思齐 吴宪吉 于炆希 张广[1] DUAN Chengcheng;SHEN Keyu;XIAO Siqi;WU Xianji;YU Wenxi;ZHANG Guang(Department of Thyroid Surgery,China-Japan Union Hospital of Jilin University,Jilin Provincial Key Laboratory of Surgical Translational Medicine,Jilin Provincial Engineering Laboratory of Thyroid Disease Prevention and Control,Changchun 130033,P.R.China)

机构地区：[1]吉林大学中日联谊医院甲状腺外科,吉林省外科转化医学重点实验室,吉林省甲状腺疾病防治工程实验室,长春130033

出　　处：《中国普外基础与临床杂志》2023年第12期1507-1513,共7页Chinese Journal of Bases and Clinics In General Surgery

基　　金：吉林省教育厅“十三五”科学技术项目(项目编号:JJKH20201055KJ)。

摘　　要：目的 总结合并桥本甲状腺炎(Hashimoto thyroiditis,HT)的甲状腺乳头状癌(papillary thyroid carcinoma,PTC)颈部淋巴结转移的特征。方法 收集近年来有关合并HT的PTC颈部淋巴结转移研究的相关文献并进行归纳总结。结果 与未合并HT的PTC患者相比,合并HT的PTC患者可探及更多肿大淋巴结,但中央区淋巴结转移率较低,颈侧区淋巴结转移情况仍存在争议;患者为男性、年轻以及肿瘤直径较大、腺外侵犯、多灶癌、BRAF基因突变、甲状腺过氧化物酶抗体和甲状腺球蛋白抗体水平高可作为术前评估合并HT的PTC患者颈部淋巴结转移的危险因素,甲状腺结节纵横比>1、极低回声、钙化和淋巴结钙化、液化、淋巴门消失等超声特征可以用来评估合并HT的PTC患者的淋巴结转移情况。结论 从本综述的结果提示,合并HT的PTC患者的中央区淋巴结转移率较低,颈侧区淋巴结转移情况有待探究,结合相关危险因素与超声影像特征可帮助评估颈部淋巴结情况,为早期发现转移淋巴结和制定个体化的手术方案提供依据并改善患者的预后。Objective To summarize the characteristics of cervical lymph node metastasis(LNM)in the papillary thyroid carcinoma(PTC)coexisting with Hashimoto thyroiditis(HT).Method The literatures related to cervical LNM of PTC coexisting with HT in recent years were collected and summarized.Results Compared with the PTC patients without HT,the more enlarged lymph nodes could be detected,and the cervival central LNM rate was lower,but there was still controversy about cervival lateral LNM in the patients with PTC coexisting with HT.The male,young,large tumor diameter,extraglandular invasion,multifocal cancer,BRAF gene mutation,and higher thyroid peroxidase antibody and thyroglobulin antibody levels,as well as the ultrasound features such as thyroid nodule aspect ratio>l,extremely low echo,calcification,and lymph node calcification,liquefaction,and disappearance of hilar lymph nodes could be used to evaluate the risk factors of cervical LNM for the patients with PTC coexisting with HT.Conclusions From the results of this review,it is suggests that the rate of central LNM is lower in patients with PTC coexisting with HT,but the status of LNM in the cervical lateral region remains to be explored.The relevant risk factors in combination with ultrasonic characteristics could help evaluate cervical lymph node status,could provide basis for early detection of metastatic lymph nodes and the formulation of individualized surgical plans,and improve the prognosis of patients.

关 键 词：桥本甲状腺炎 甲状腺乳头状癌 颈部淋巴结转移 危险因素 超声特征 

分 类 号：R736.1[医药卫生—肿瘤] R581.4[医药卫生—临床医学]