甲状腺微小乳头状癌颈部淋巴结转移的危险因素分析

发布时间：2018-03-17 10:38

本文选题：甲状腺肿瘤　切入点：淋巴转移　出处：《中国普通外科杂志》2016年11期 　论文类型：期刊论文

【摘要】：目的:探讨甲状腺微小乳头状癌(PTMC)颈部淋巴结转移的危险因素。方法:回顾性分析贵州医科大学附属医院甲状腺外科2014年1月—2016年3月收治的169例PTMC患者临床病理资料。结果:169例患者均行预防性中央区淋巴结清扫,其中54例(32.0%)发生中央区淋巴结转移,单因素分析发现中央区淋巴结转移与年龄45岁、多灶性肿瘤、侵出包膜有关(均P0.05),多因素分析显示,年龄、多灶性肿瘤、侵出包膜都是中央区淋巴结转移的独立危险因素(均P0.05)。30例行中央区淋巴结加侧颈区淋巴结清扫,其中18例(10.7%)发生侧颈区淋巴结转移,单因素分析显示,肿瘤最大径、侵出包膜、多灶性肿瘤、中央区淋巴结转移与侧颈区淋巴结转移有关(均P0.05),多因素分析显示,肿瘤侵出包膜为侧颈区淋巴结转移的高危因素(P0.05);11例(6.5%)发生中央区并侧颈区淋巴结转移,侵出包膜、多灶性肿瘤为中央区并侧颈区淋巴结共同发生转移的高危因素(均P0.05)。高分辨率颈部淋巴结B超对中央区淋巴结转移的灵敏度、特异度分别为14.8%、96.5%,其对侧颈区淋巴结转移的灵敏度、特异度分别为94.4%、83.3%。结论:年龄45岁、多灶性肿瘤、侵出包膜是PTMC颈部淋巴结转移的危险因素。高分辨率颈部淋巴结B超可以作为甲状腺癌颈部淋巴结转移术前评估的重要手段。
[Abstract]:Objective: to investigate the risk factors of cervical lymph node metastasis in patients with parathyroid micropapillary carcinoma of thyroid (PTMC). Methods: a retrospective analysis of 169 patients with PTMC from January 2014 to March 2016 was performed in the Department of thyroid surgery, affiliated Hospital of Guizhou Medical University. Results all 169 patients underwent preventive central lymph node dissection. Among them, 54 cases (32.0%) developed central lymph node metastasis. Univariate analysis showed that central lymph node metastasis was related to age 45 years old, multifocal tumor, invading capsule (all P0.05%, multivariate analysis showed that age, multi-focal tumor). The invasion of capsule was an independent risk factor for lymph node metastasis in the central region (P0.05%. 30 cases were treated with lymph node dissection in the central region plus neck region, 18 cases had lymph node metastasis in the lateral neck region). Univariate analysis showed that the largest diameter of the tumor was the invasion of the capsule. Multiple focal tumors, central lymph node metastasis were associated with lateral cervical lymph node metastasis (all P0.05%, multivariate analysis showed that tumor capsule invasion was a high risk factor for lateral cervical lymph node metastasis in 11 cases (P 0.05)). Multiple focus tumors were the high risk factors of lymph node metastasis in the central and lateral cervical region (all P0.05). Sensitivity of high resolution cervical lymph node B ultrasound to the metastasis of the central lymph node. The sensitivity and specificity of lymph node metastasis in the contralateral cervical region were 94. 4% and 83. 3% respectively. Conclusion: age 45 years old, multifocal tumor, Invasion of capsule is a risk factor for cervical lymph node metastasis in PTMC. High-resolution cervical lymph node B ultrasound can be used as an important method for preoperative evaluation of cervical lymph node metastasis in thyroid carcinoma.
【作者单位】：贵州医科大学附属医院甲状腺外科;贵州医科大学第二附属医院甲状腺外科;
【分类号】：R736.1

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