多灶性甲状腺乳头状癌的临床病理及颈淋巴结转移特征

发布时间：2018-05-26 05:02

  本文选题：甲状腺肿瘤 + 癌　； 参考：《中国普通外科杂志》2017年05期

【摘要】：目的:探讨多灶性甲状腺乳头状癌(PTC)的临床病理及颈淋巴结转移特征。方法:回顾性分析2016年6月—2016年10月于郑州大学第一附属医院甲状腺外科行手术治疗并经术后病理证实的323例PTC患者的临床资料,其中多灶性PTC患者148例,单灶性PTC患者175例。结果:多灶性PTC患者与单灶性PTC患者间性别、年龄、癌灶最大径差异无统计学意义(均P0.05),但前者更易发生颈部中央区淋巴结转移(P0.001)、颈侧区淋巴结转移(P=0.028)及腺外浸润(P0.001);多灶性PTC患者中,癌灶数≥3的患者中央区淋巴结转移率(P=0.010)、侧区淋巴结转移率(P=0.018)及腺外浸润的发生率(P=0.020)明显高于癌灶数=2的患者;多因素分析显示,癌灶最大径(P=0.005)及癌灶数量(P=0.006)为多灶性PTC中央区淋巴结转移的独立危险因素。结论:多灶性PTC较单灶性PTC侵袭性强,更易发生转移、浸润,建议选择全甲状腺切除加中央区淋巴结清扫作为标准化手术方式,颈侧区存在可疑肿大淋巴结者应积极行颈侧区淋巴结清扫术。
[Abstract]:Objective: to investigate the clinicopathological and cervical lymph node metastasis of multi-focal papillary thyroid carcinoma (PTC). Methods: the clinical data of 323 patients with PTC who were treated surgically in the first affiliated Hospital of Zhengzhou University from June 2016 to October 2016 and proved by pathology were retrospectively analyzed, including 148 patients with multifocal PTC. 175 patients with single focus PTC. Results: the sex and age of patients with multifocal PTC and single focus PTC were analyzed. There was no significant difference in the maximum diameter of the tumor (all P 0.05, but the former was more likely to develop cervical central lymph node metastasis (P0.001), cervical lateral lymph node metastasis (P0.028) and extraglandular invasion (P0.001). The rate of lymph node metastasis in the central region and lateral region were significantly higher in the patients with tumor number 鈮，

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