甲状腺乳头状癌淋巴结转移率和远处转移的关系

发布时间：2018-04-23 02:19

本文选题：甲状腺乳头状癌 + 淋巴结转移率　；参考：《中国癌症杂志》2017年01期

【摘要】：背景与目的:颈部淋巴结转移在甲状腺乳头状癌(papillary thyroid carcinoma,PTC)中多见。该研究旨在探讨PTC淋巴结转移率(the rate of involved lymph nodes,LR)与远处转移(distant metastasis,DM)的关系,及其对DM的预测价值。方法:随访162例PTC患者,将其分为DM组(M_1组)41例和非DM组(M_0组)121例,采用t检验、χ~2检验分别比较两组患者的基本病理特征。采用多因素分析评估LR在预测DM的意义。利用受试者工作特征(receiver operating characteristic curve,ROC)曲线及最佳诊断界值点评估LR及淋巴结转移数目(the number of involved lymph nodes,LNs)对DM的预测价值,进一步采用Kaplan-Meier曲线评估LR及LNs发生DM的累积风险,使用Log-rank法对差异进行统计学分析。结果:两组患者在年龄及多灶性方面差异无统计学意义(P0.05),在男性(χ~2=13.039,P=0.000)、腺外侵犯(χ~2=2.941,P=0.000)、病灶大小(t=-4.485,P=0.000)方面存在显著差异。LR可以作为预测DM的独立因素(OR=1.133,P=0.000)。随着LR的增高,LNs大于等于15组患者的DM风险显著高于LNs小于15组(P=0.0002)。结论:LR可作为DM的独立预测指标,其与LNs结合可以更好地预测DM的发生风险。
[Abstract]:Background & objective: cervical lymph node metastasis is common in papillary thyroid carcinoma of thyroid. The purpose of this study was to investigate the relationship between the rate of involved lymph nodesla (PTC) and distant metastatic lymph node (PTC) and its predictive value for DM. Methods: 162 patients with PTC were followed up and divided into DM group (n = 41) and non-DM group (n = 121). T test and 蠂 2 test were used to compare the basic pathological features of the two groups. Multivariate analysis was used to evaluate the significance of LR in DM prediction. The predictive value of LR and the number of lymph node metastasis (LNs) to DM was evaluated by receiver operating characteristic curve and optimal diagnostic threshold. Kaplan-Meier curve was used to evaluate the cumulative risk of DM in LR and LNs. Log-rank method was used to analyze the difference. Results: there was no significant difference in age and multifocal sex between the two groups (P 0.05). There were significant differences in age and multi-focus between the two groups (蠂 2 / 13.039 / P = 0.000), extraglandular invasion (蠂 ~ (2 / 2) 2.941 / P 0.000), and the size of the lesion (t = -4.485 / P ~ (0.000)). LR could be used as an independent predictor of DM. With the increase of LR, the DM risk of patients with LNs greater than or equal to 15 was significantly higher than that of patients with LNs less than 15. Conclusion the ratio LR can be used as an independent predictor of DM, and its combination with LNs can better predict the risk of DM.
【作者单位】：中国医科院学院北京协和医学院北京协和医院核医学科;青岛大学附属医院肿瘤科;北京大学国际医院肿瘤科;中国医学科学院北京协和医学院北京协和医院基本外科;
【基金】：国家自然科学基金(81571714) 卫生部行业科研专项项目(201202012)
【分类号】：R736.1

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