男性甲状腺微小乳头状癌临床特点及中央区淋巴结转移危险因素分析  

Clinical characteristics and risk factors of central lymph node metastasis in male papillary thyroid microcarcinoma

作　　者：季振华[1] 蒋斌[1] 陈卫贤[1] 戴文成[1] 张钦鑫 JI Zhenhua;JIANG Bin;CHEN Weixian;DAI Wencheng;ZHANG Qinxin(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》2024年第2期107-111,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微小乳头状癌的临床特点,并探讨其发生中央区淋巴结转移的危险因素。方法回顾分析2018年1月—2022年12月我科收治的首次手术治疗的甲状腺微小乳头状癌患者共743例,男性152例作为研究组,女性591例作为对照组,比较2组患者的临床病理资料,并使用单因素和多因素统计学方法分析男性甲状腺微小乳头状癌患者中央区淋巴结转移的危险因素。结果2组患者年龄、肿瘤最大径、肿瘤多灶性、肿瘤分布及颈侧区淋巴结转移差异均无统计学意义(P值均>0.05),2组患者肿瘤包膜侵犯、合并桥本甲状腺炎及中央区淋巴结转移情况差异均具有统计学意义(P值均<0.01)。单因素分析显示肿瘤最大径>5 mm、多灶、双侧分布、有包膜侵犯为男性甲状腺微小乳头状癌患者中央区淋巴结转移的危险因素,二元logistic多因素回归分析显示肿瘤最大径>5 mm、包膜侵犯为男性甲状腺微小乳头状癌患者发生中央区淋巴结转移的独立危险因素。结论相对于女性甲状腺微小乳头状癌患者,男性甲状腺微小乳头状癌患者更易出现包膜侵犯,中央区淋巴结转移率更高。临床对于肿瘤最大径>5 mm、有包膜侵犯的男性甲状腺微小乳头状癌患者要尤为重视中央区淋巴结的清扫。Objective To analyze the clinical features of male papillary thyroid micro carcinoma(PTMC)and the risk factors of central lymph node metastasis(CLNM).Methods A total of 743 patients with PTMC who had undergone primary operation in our department from January 2018 to December 2022 were retrospectively analyzed,with 152 male patients as the study group and 591 female patients as the control group.The clinical and pathological data of the two groups were compared.Univariate and multivariate statistical methods were used to analyze the risk factors of CLNM in male PTMC patients.Results There were no significant differences in age,maximum tumor diameter,multifocal tumor,tumor distribution and lateral cervical lymph node metastasis between the two groups(P>0.05),but there were significant differences in tumor capsule invasion,combined with Hashimoto thyroiditis(HT)and CLNM between the two groups(P<0.01).Univariate analysis showed that the maximum tumor diameter>5 mm,multi-focal,bilateral distribution and capsule invasion were risk factors for CLNM in male PTMC patients,while binary Logistic multivariate regression analysis showed that the maximum tumor diameter>5 mm and capsule invasion were independent risk factors for CLNM in male PTMC patients.Conclusion Male PTMC patients are more prone to capsule invasion and CLNM.Special attention should be paid to the central lymph nodes dissection of male PTMC patients especially those with tumor maximum diameter>5 mm or capsular invasion.

关 键 词：男性 甲状腺微小乳头状癌 中央区淋巴结 转移 

分 类 号：R76[医药卫生—耳鼻咽喉科] R736.1[医药卫生—临床医学]