甲状腺乳头状癌颈淋巴结转移的影响因素分析  

Analysis of factors influencing cervical lymph node metastasis in papillary thyroid cancer

作　　者：汪洁[1] 张行 WANG Jie;ZHANG Hang(Department of Imaging and Functional Examination,Hefei Ion Medical Center,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei,Anhui,230000,China;Department of Ultrasound Medicine,the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Hefei,Anhui,230000,China)

机构地区：[1]中国科学技术大学附属第一医院离子医学中心(合肥离子医学中心),影像与功能检查科,安徽合肥230000 [2]中国科学技术大学附属第一医院(安徽省立医院),超声医学科,安徽合肥230000

出　　处：《中国耳鼻咽喉头颈外科》2025年第1期13-16,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探索甲状腺乳头状癌患者颈淋巴结转移的影响因素及与超声特征和BRAF V600E突变的相关性。方法回顾性分析2022年10月~2023年3月中国科学技术大学附属第一医院(安徽省立医院)收治的120例甲状腺乳头状癌患者,分析患者颈淋巴结转移与超声特征及BRAF V600E突变的关系。结果共纳入甲状腺癌患者120例,淋巴结转移率为60.00%(72/120),BRAF V600E突变率为79.17%(95/120)。不同BRAF V600E突变与颈淋巴结转移之间的差异无统计学意义(χ^(2)=1.895,P=0.169)。纵横比>1、病灶多发、钙化、血流丰富、病灶直径≥1 cm是发生颈淋巴结转移的危险因素(OR=3.448,P=0.009;OR=3.758,P=0.008;OR=2.834,P=0.047;OR=3.552,P=0.024;OR=3.521,P=0.031),年龄>40岁是发生颈淋巴结转移的保护性因素(OR=0.357,P=0.024)。结论应对年龄≤40岁,超声表现为纵横比>1、病灶多发、病灶直径≥1 cm、钙化、血流丰富的甲状腺乳头状癌患者重点关注淋巴结转移情况,选择合适的治疗方法和制定合理的淋巴结清扫范围。OBJECTIVE To explore the relationship between cervical lymph node metastasis of thyroid cancer and ultrasound features,as well as BRAF V600E mutation.METHODS A retrospective study was conducted on 120 patients admitted to the First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China between October 2022 and March 2023 to analyze the relationship between neck lymph node metastasis,ultrasound features,and BRAF V600E mutation.RESULTS A total of 120 thyroid cancer patients were included,with a lymph node metastasis rate of 60.00%(72/120)and a BRAF V600E mutation rate of 79.17%.There was no statistically significant difference between different BRAF V600E mutations and cervical lymph node metastasis(χ^(2)=1.895,P=0.169).More than 1 aspect ratio,multiple lesions,calcification,rich blood flow,and lesion diameter≥1 cm are risk factors for lymph node metastasis(OR=3.448,P=0.009;OR=3.758,P=0.008;OR=2.834,P=0.047;OR=3.552,P=0.024;OR=3.521,P=0.031),Age>40 years old is a protective factor for lymph node metastasis(OR=0.357,P=0.024).CONCLUSION For papillary thyroid carcinoma patients aged≤40 years,with ultrasound findings of aspect ratio>1,multiple lesions,lesion diameter≥1 cm,calcification,and abundant blood flow,special attention should be paid to lymph node metastasis,appropriate treatment methods should be selected,and a reasonable lymph node dissection range should be formulated.

关 键 词：甲状腺肿瘤 乳头状甲状腺癌 淋巴结转移 影响因素 

分 类 号：R736.1[医药卫生—肿瘤]