甲状腺微小乳头状癌中央区淋巴结转移危险因素的研究  

Risk factors of central regional lymph node metastasis in micropapillary thyroid neoplasms

作　　者：罗志委 吉鸿利 连金山 陈雅梅 高江 王龙龙[2] Luo Zhiwei;Ji Hongli;Lian Jinshan;Chen Yamei;Gao Jiang;Wang Longlong(Department of General Surgery,the First Hospital of Handan City,Handan 056002,China;Department of Head and Neck,Baotou Cancer Hospital,Baotou 014030,China;Graduate School of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014060,China)

机构地区：[1]邯郸市第一医院普外科,邯郸056002 [2]包头市肿瘤医院头颈二科,包头014030 [3]内蒙古科技大学包头医学院研究生院,包头014060

出　　处：《中华普通外科杂志》2025年第3期213-216,共4页Chinese Journal of General Surgery

摘　　要：目的探讨甲状腺微小乳头状癌(PTMC)中央区淋巴结转移(CLNM)的危险因素。方法回顾性分析2021年10月至2023年3月包头市肿瘤医院收治的304例PTMC患者的临床病理资料,采用单因素及多因素回归分析CLNM的危险因素。结果本组304例PTMC患者CLNM率为46.7%(142/304)。单因素分析显示,男性、年龄<45岁、最大肿瘤直径≥5 mm、肿瘤总直径≥9.5 mm、肿瘤前后径≥5 mm、肿瘤甲状腺前后径比≥0.48、突破被膜、癌灶侧淋巴结数量≥5枚、抗甲状腺过氧化物酶抗体≤34 IU/ml均与CLNM有关(均P<0.05);Logistic多因素回归分析显示,男性、年龄<45岁、肿瘤总直径≥9.5 mm(OR=2.052,95%CI:1.176~3.581,P=0.011)、肿瘤甲状腺前后径比≥0.48(OR=2.076,95%CI:1.161~3.711,P=0.014)、癌灶侧淋巴结数量≥5枚、抗甲状腺过氧化物酶抗体≤34 IU/ml是CLNM的独立危险因素。结论男性、年龄、肿瘤总直径、肿瘤甲状腺前后径比、癌灶侧淋巴结数量、抗甲状腺过氧化物酶抗体水平均是PTMC患者发生CLNM的危险因素。Objective To explore potential risk factors for central lymph node metastasis(CLNM)in papillary thyroid microcarcinoma(PTMC).Methods The clinicopathological data of 304 PTMC patients admitted to Baotou Cancer Hospital from Oct 2021 to Mar 2023 were retrospectively analyzed.The risk factors of CLNM were analyzed using unifactorial and multifactorial regression.Results The rate of central regional lymph node metastasis in 304 patients with PTMC was 46.7%(142/304).Univariate analysis showed that male,age<45 years,maximum cancerous lesion diameter≥5 mm,total cancerous lesion diameter≥9.5 mm,anterior-posterior lesion diameter≥5 mm,anterior-posterior lesion diameter ratio of cancerous lesions≥0.48,breaching of thyroid capsule,number of lymph nodes on the side of cancerous lesions≥5,and antithyroid peroxidase antibody≤34 IU/ml were associated with CLNM(all P<0.05);Logistic multivariate regression analysis showed that.male,age<45 years,total diameter of cancer foci≥9.5 mm(OR=2.052,95%CI:1.176-3.581,P=0.011),anteroposterior diameter ratio of cancer foci≥0.48(OR=2.076,95%CI:1.161-3.711,P=0.014),number of lymph nodes on the side of cancer foci≥5,and anti-thyroid peroxidase antibody≤34 IU/ml were independent risk factors for CLNM.Conclusion Male,age,total diameter of cancer foci,anterior-posterior diameter ratio of cancer foci,number of lymph nodes on the side of cancer foci,and anti-thyroid peroxidase antibody level are all independent risk factors for CLNM in patients with PTMC.

关 键 词：甲状腺癌 乳头状 淋巴转移 危险因素 

分 类 号：R73[医药卫生—肿瘤]