甲状腺微小乳头状癌侧颈区淋巴结转移危险因素分析——附2例病例报告  

Risk factors of lateral lymph node metastasis in papillary thyroid carcinoma with two case reports

作　　者：李栋梁 刘九洋[2] LI Dongliang;LIU Jiuyang(Dept.of Gastrointestinal Surgery,Xishui People's Hospital,Huanggang 438299,Huibei,China;Dept.of Thyroid and Breast Surgery,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)

机构地区：[1]浠水县人民医院胃肠外科,湖北黄冈438299 [2]武汉大学中南医院甲状腺乳腺外科,湖北武汉430071

出　　处：《武汉大学学报(医学版)》2025年第3期343-349,共7页Medical Journal of Wuhan University

摘　　要：甲状腺乳头状癌发病率逐年升高,其中甲状腺微小乳头状癌占比约50%左右。但是因为甲状腺微小乳头状癌进展慢、预后较好,人们往往忽略了其属于恶性肿瘤的本质。我们在长期的临床实践中发现部分“小肿瘤,大转移”的病例,其发生率为1%~11.2%,相对少见,且早期易漏诊,部分以颈部淋巴结肿大为主要症状就诊。因此,探究甲状腺微小乳头状癌侧颈区转移的风险因素对临床医生判断淋巴结清扫范围、降低患者复发率具有重要意义。一般而言,侧颈部淋巴结转移的风险因素主要包括:性别、年龄、肿瘤大小、肿瘤位置、多灶性、腺外侵袭、组织学亚型、基因突变、中央区淋巴结转移。本文主要通过文献复习,并结合两例甲状腺微小乳头状癌伴颈部淋巴结转移的典型病例,分析潜在风险因素,以提高对此类疾病认识。The incidence of papillary thyroid cancer is increasing year by year,with thyroid micropapillary carcinoma accounting for about 50%.Because papillary thyroid carcinoma progresses slowly and has a better prognosis,its malignant nature is often overlooked.Some cases of"tiny tumor and large metastasis"which occur at a rate of 1%to 11.2%,are relatively rare and easily missed in clinical practice.These cases may also present with palpable lateral lymphadenopathy.Therefore,it is important to explore the risk factors of lateral lymph node metastasis in papillary thyroid carcinoma for clinicians to determine the extent of lymph node dissection and reduce the recurrence rate.Generally,risk factors for lateral lymph node metastasis include gender,age,tumor size,tumor location,multifocality,extrathyroidal extension,histological subtypes,genetic mutations,and central lymph node metastases.In this article,we analyzed potential risk factors to improve understanding of papillary thyroid carcinoma with lateral lymph node metastasis through a literature review and in combination with two typical cases of this disease.

关 键 词：甲状腺微小乳头状癌 侧颈区淋巴结转移 风险因素 病例报告 

分 类 号：R736.1[医药卫生—肿瘤]