cN0甲状腺微小乳头状癌多个淋巴结转移的危险因素分析

发布时间：2018-03-31 09:27

  本文选题：甲状腺微小乳头状癌　切入点：cN　出处：《中国肿瘤临床》2017年16期

【摘要】：目的:术后病理证实的淋巴结转移在临床淋巴结转移阴性(clinical lymph node negative,cN0)的甲状腺乳头状癌(papillary thyroid carcinoma,PTC)中并不罕见,本研究旨在探讨临床淋巴结转移阴性的甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)淋巴结转移的危险因素,特别是多个淋巴结转移(5枚)的危险因素。方法:回顾性分析中国医学科学院北京协和医院2013年11月至2014年10月行手术的cN0 PTMC患者1 268例,其中男性270例,女性998例。分析患者的临床病理学特征,通过单因素、多因素分析寻找淋巴结转移及多个转移的风险因素。结果:1 268例患者中共出现淋巴结转移416例(32.8%),多个淋巴结转移43例(3.4%),淋巴结转移的危险因素的单因素分析中,男性(42.22%vs.30.26%,P0.01)、年龄40岁(40岁为48.39%,40~59岁为27.62%,年龄≥60岁为22.45%,P0.03)、多发病灶(41.00%vs.29.03%,P0.01)、无慢性淋巴细胞性甲状腺炎(36.44%vs.20.62%,P0.01)、肿瘤直径0.5 cm(35.77%vs.23.05%,P0.01)者淋巴结转移比例显著增加。多因素分析中,男性(OR=1.516,P0.001)、多发病灶(OR=1.743,P0.001)、肿瘤直径0.5 cm(OR=1.788,P0.001)是淋巴结转移的独立危险因素;而年龄较大患者(40~59岁OR=0.388;60岁及以上OR=0.301,P0.001)、慢性淋巴细胞性甲状腺炎(OR=0.472,P0.001)是出现淋巴结转移的保护性因素。在多个淋巴结转移危险因素的多因素分析中,男性(OR=2.383,P=0.002)是多个淋巴结转移的独立危险因素;而年龄≥40岁则是保护性因素(OR=0.270,P0.001)。结论:cN0 PTMC淋巴结转移并不少见,但是多个淋巴结转移少见,男性、年龄40岁的患者淋巴结转移、多个转移的风险明显增加。
[Abstract]:Objective: postoperative pathologically confirmed lymph node metastasis is not uncommon in papillary thyroid carcinoma of thyroid gland with clinical lymph node metastasis negative lymph node negativecN0.The aim of this study was to investigate the risk factors of papillary thyroid micrometastasis, especially 5 lymph node metastases, in papillary thyroid microcarcinoma of thyroid micropapillary carcinoma with negative lymph node metastasis.Methods: a total of 1 268 cN0 PTMC patients, including 270 males and 998 females, underwent surgery in Peking Union Hospital of the Chinese Academy of Medical Sciences from November 2013 to October 2014 were retrospectively analyzed.The clinicopathological features of the patients were analyzed and the risk factors of lymph node metastasis and multiple metastasis were analyzed by univariate and multivariate analysis.Results there were 416 cases with lymph node metastasis in 1 268 cases, 43 cases with multiple lymph node metastasis, and 3.4 cases with multiple lymph node metastasis. The risk factors of lymph node metastasis were analyzed.In multivariate analysis of risk factors for multiple lymph node metastasis, male ORA 2.383 P0. 002) was an independent risk factor for multiple lymph node metastasis, while age 鈮，

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