甲状腺乳头状微小癌及PTC侧方淋巴结转移的危险因素研究
发布时间：2018-12-29 14:42
【摘要】：目的:分析甲状腺微小结节患者的临床病理特征和甲状腺乳头状癌患者侧颈区淋巴结转移的相关指标,提高对甲状腺微小结节和侧颈部淋巴结转移的早期诊治水平。避免过度和延误治疗的发生。方法:选择就诊于新疆医科大学附属医院2011年1月至2015年12月间,经超声TI-RADS分级标准诊断为3级或4a级的108例甲状腺微小结节患者和进行侧颈部淋巴结清扫术的96例患者,分别进行随访观察和病例资料的回顾性分析。其中门诊和电话随访截止至2015年9月,以随访结束时患者甲状腺结节是否为恶性作为统计分析的终点事件;回顾分析病例资料中Ki-67、CD56、糖链抗原19-9的表达情况、Ⅵ区淋巴结个数与侧方淋巴结转移之间的关系。结果:随访研究中有23例患者出现疾病进展,经术后病理诊断为甲状腺微小癌。甲状腺微小良性结节和甲状腺微小癌患者性别、年龄、结节数目、是否为多中心肿瘤、TI-RADS分级比较,差异均有统计学意义(P0.05);两者是否合并其他甲状腺疾病、是否规律服用抑制TSH药物比较,差异均无统计学意义(P0.05)。多因素Logistic回归分析结果显示,男性、多发结节、多中心肿瘤、TI-RADS分级为4a级是甲状腺微小癌的影响因素(P0.05)。关于侧方淋巴结转移的四项研究指标中,Ⅵ区淋巴结转移个数≥5个对提示侧方淋巴结转移有统计学意义(P0.05)。结论:存在男性、多发结节、多中心肿瘤、TI-RADS分级为4a级这些高危因素的甲状腺微小结节患者应考虑积极手术治疗,不适宜作为长期随访对象。Ⅵ区淋巴结转移个数≥5个的患者宜考虑早期行侧颈部淋巴结清扫术。
[Abstract]:Objective: to analyze the clinicopathological features of thyroid micronodule and the related indexes of lymph node metastasis in the lateral cervical region of patients with papillary thyroid carcinoma, so as to improve the early diagnosis and treatment of thyroid micronodule and lateral cervical lymph node metastasis. Avoid excessive and delayed treatment. Methods: from January 2011 to December 2015, 108 patients with grade 3 or grade 4a thyroid micronodules and 96 patients undergoing lateral neck lymph node dissection were selected according to the TI-RADS classification criteria. Follow-up observation and retrospective analysis of case data were carried out. The end point of statistical analysis was whether thyroid nodules were malignant or not at the end of follow-up. The expression of Ki-67,CD56, carbohydrate antigen 19-9 and the relationship between the number of lymph nodes in region 鈪，
本文编号：2394968
[Abstract]:Objective: to analyze the clinicopathological features of thyroid micronodule and the related indexes of lymph node metastasis in the lateral cervical region of patients with papillary thyroid carcinoma, so as to improve the early diagnosis and treatment of thyroid micronodule and lateral cervical lymph node metastasis. Avoid excessive and delayed treatment. Methods: from January 2011 to December 2015, 108 patients with grade 3 or grade 4a thyroid micronodules and 96 patients undergoing lateral neck lymph node dissection were selected according to the TI-RADS classification criteria. Follow-up observation and retrospective analysis of case data were carried out. The end point of statistical analysis was whether thyroid nodules were malignant or not at the end of follow-up. The expression of Ki-67,CD56, carbohydrate antigen 19-9 and the relationship between the number of lymph nodes in region 鈪，
本文编号：2394968
本文链接：https://www.wllwen.com/yixuelunwen/zlx/2394968.html
