cN0期甲状腺微小乳头状癌切除术后复发影响因素分析  

Analysis of the factors influencing the recurrence of stage cN0 thyroid micropapillary carcinoma after resection

作　　者：彭文定 苗辉辉 Peng Wen-ding;Miao Hui-hui(Department of Thyroid Surgery,Anyang People's Hospital,Anyang 455000,Henan,China;Department of Preventive Medicine,Henan Vocational College of Nursing,Anyang 455000,Henan,China)

机构地区：[1]安阳市人民医院甲状腺外科,河南安阳455000 [2]河南护理职业学院预防医学,河南安阳455000

出　　处：《四川生理科学杂志》2024年第12期2655-2658,共4页

摘　　要：目的:探讨影响cN0期甲状腺微小乳头状癌切除术后复发的危险因素。方法:回顾性选取2021年1月至2023年3月于我院接受甲状腺切除术并于1 y后随访复发的cN0期PTMC患者41例作为复发组。另选取同期于本院行相同治疗,但1 y后随访未见复发的cN0期PTMC患者71例作为未复发组。所有患者均行患侧甲状腺叶切除术±峡部切除+同侧中央区淋巴结清扫。检测所有患者的血清促甲状腺激素(TSH)、抗甲状腺过氧化物酶抗体(TPOAb)、促甲状腺素受体抗体(TgAb)水平。收集并比较患者的基线资料。采用单因素、多因素Logistic回归分析影响cN0期PTMC切除术后复发的危险因素,并进行受试者工作曲线(ROC)分析。结果:单因素分析显示,两组的性别、年龄、最大肿瘤直径、术前血清TSH水平、TgAb阳性比较均有显著差异(P<0.05),BMI、是否多灶、是否被膜/腺外侵犯、TPOAb阳性比较无显著差异(P>0.05)。多因素Logistic回归分析显示年龄、最大肿瘤直径、TSH水平、TgAb阳性均是cN0期PTMC切除术后复发的影响因素。结论:男性、年龄<45岁、最大肿瘤直径≥5 mm、术前血清TSH水平升高、TgAb阳性是cN0期PTMC切除术后复发的独立危险因素。年龄、TSH水平对cN0期PTMC切除术后复发有一定预测价值。Objective:To investigate the risk factors for recurrence of stage cN0 thyroid micropapillary carcinoma after resection.Methods:41 cN0 stage PTMC patients who received thyroidectomy in our hospital from January 2021 to March 2023 and relapsed 1 year later were retrospectively selected as the relapse group.Another 71 patients with cN0 stage PTMC who received the same treatment in our hospital during the same period,but did not find recurrence after 1 year follow-up were selected as the non-recurrence group.All patients underwent thyroidectomy±isthmus resection plus ipsilateral central lymph node dissection.Serum levels of thyroid stimulating hormone(TSH),anti-thyroid peroxidase antibody(TPOAb)and thyrotropin receptor antibody(TgAb)were detected in all patients.Baseline data were collected and compared.Univariate and multivariate Logistic regression were used to analyze the risk factors of relapse after cN0 PTMC resection,and receiver operating curve(ROC)analysis was performed.Results:Unifactorial analysis showed that there were significant differences in gender,age,maximum tumor diameter,preoperative serum TSH level and TgAb positive between the two groups(P<0.05),but there were no significant differences in BMI,whether it was multifocal,whether it was extrinsic membrane/gland invasion and TPOAb positive between the two groups(P>0.05).Multivariate Logistic regression analysis showed that age,maximum tumor diameter,TSH level and positive TgAb were all influencing factors for recurrence after cN0 PTMC resection.Conclusion:Male,age<45 years,maximum tumor diameter≥5mm,elevated serum TSH level before surgery,and positive TgAb are independent risk factors for recurrence after cN0 PTMC resection.Age and TSH level have certain predictive value for recurrence of cN0 stage PTMC after resection.

关 键 词：CN0 PTMC 切除术后 复发 中央区淋巴结转移 

分 类 号：R736.1[医药卫生—肿瘤]