甲状腺微小癌侧颈淋巴结转移危险因素分析

发布时间：2018-03-04 04:30

本文选题：甲状腺微小癌　切入点：侧颈淋巴结转移　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：背景和目的:虽然大多数甲状腺微小癌有非常好的预后,但仍有一部分表现出了极强的侵袭性,例如发生侧颈淋巴结转移,而对其发生的机制及危险因素尚不明确。本研究的目的是探究甲状腺微小癌(PTMC)发生侧颈转移的危险因素,从而帮助我们在术前为患者制定更为适当的手术方案。方法:回顾性分析在2014年5月至2016年5月于吉林大学第一医院甲状腺外科住院行手术治疗的共1231位PTMC患者的临床病理及遗传学特点。其中PTMC未合并侧颈淋巴结转移1129例,PTMC合并侧颈淋巴结转移102例。结果:在单变量分析中,两组患者在性别、年龄、肿瘤大小、多灶性、是否侵犯双侧叶甲状腺、被膜侵犯、腺外侵犯、中央区淋巴结转移上有明显差异(p0.05)。而在BRAF基因突变、是否合并桥本甲状腺炎、术前TSH及甲状腺球蛋白抗体水平上无明显差异(p0.05)。多因素回归分析显示,男性(OR=2.588),肿瘤直径0.5cm(OR=2.586),多病灶(OR=2.384)、腺外侵犯(OR=2.533)、中央区淋巴结转移术3枚(OR=8.123)是PTMC侧颈淋巴结转移的独立危险因素。结论:男性、肿瘤直径0.5cm、多病灶、侵犯脉管及腺外组织、中央区淋巴结转移数3枚的PTMC患者有较高的侧颈淋巴结转移风险。BRAF基因突变不是PTMC侧颈淋巴结转移的预测指标。
[Abstract]:Background and objective: although most thyroid microcarcinomas have a very good prognosis, some still exhibit extremely aggressive features, such as lateral cervical lymph node metastasis. However, the mechanism and risk factors of its occurrence are not clear. The aim of this study was to investigate the risk factors of lateral cervical metastasis in thyroid microcarcinoma PTMCs. Methods: from May 2014 to May 2016, 1231 patients with PTMC underwent surgical treatment in thyroid surgery department of the first Hospital of Jilin University. Objective to investigate the clinicopathological and genetic characteristics of PTMC with lateral cervical lymph node metastasis in 1 129 cases. Results: in univariate analysis, 1 129 cases of PTMC with lateral cervical lymph node metastasis were analyzed. There were significant differences between the two groups in sex, age, tumor size, multiple foci, invasion of bilateral lobar thyroid gland, membrane invasion, extraglandular invasion, central lymph node metastasis. However, there was a significant difference between the two groups in BRAF gene mutation and Hashimoto's thyroiditis. There was no significant difference in TSH and thyroglobulin antibody levels before operation. Multivariate regression analysis showed that there was no significant difference between the two groups. In male patients, the diameter of the tumor was 0.5cm, the diameter of the tumor was 0.5cm, the diameter of the tumor was 2.586g, the tumor diameter was 0.5cm, the diameter of the tumor was 0.5cm, the lesion was 2.384m, the extraglandular invasion of ORO was 2.533m, and the central region lymph node metastasis was 3 OR8.123.Conclusion: male, the diameter of the tumor is 0.5 cm, multiple lesions, invasion of vascular and extraglandular tissue. The mutation of BRAF gene was not a predictor of lateral cervical lymph node metastasis in patients with PTMC with 3 central lymph node metastases.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R736.1

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