摘要
目的总结直径≤5 mm的甲状腺乳头状微小癌的临床特征。方法回顾性分析2015年1月至2017年12月259例行甲状腺癌根治术治疗的甲状腺乳头状微小癌患者的临床资料。将患者根据术前肿瘤直径分为>5 mm组(88例)和≤5 mm组(171例),再根据淋巴结转移情况将两组患者分为无淋巴结转移亚组和有淋巴结转移亚组,分析导致淋巴结转移的原因。结果>5 mm组和≤5 mm组性别构成、年龄及合并桥本甲状腺炎率比较差异无统计学意义(P>0.05);>5 mm组T3~4期率、N1a^1b期率及多发肿物率明显高于≤5 mm组[34.1%(30/88)比18.7%(32/171)、45.5%(40/88)比22.8%(39/171)和39.8%(35/88)比22.8%(39/171)],差异有统计学意义(P<0.05或<0.01)。在>5 mm组,有淋巴结转移亚组40例,无淋巴结转移亚组48例,有淋巴结转移亚组T3~4期率明显高于无淋巴结转移亚组[55.0%(22/40)比16.7%(8/48)],差异有统计学意义(P<0.01);在≤5 mm组,有淋巴结转移亚组39例,无淋巴结转移亚组132例,有淋巴结转移亚组T3~4期率明显高于无淋巴结转移亚组[51.3%(20/39)比9.1%(12/132)],差异有统计学意义(P<0.01)。在>5 mm组和≤5 mm组,两亚组性别构成、年龄、合并桥本甲状腺炎率和多发肿物率比较差异均无统计学意义(P>0.05)。结论直径≤5 mm甲状腺乳头状微小癌与直径>5 mm甲状腺乳头状微小癌相比,具有较小的侵袭性;在不同直径的甲状腺乳头状微小癌中,肿物是否侵犯甲状腺包膜或腺外组织对淋巴结转移有很大的影响。
Objective To summarize the clinical characteristics of papillary thyroid microcarcinoma with diameter≤5 mm.Methods The clinical data of 259 papillary thyroid microcarcinoma patients who had underwent radical thyroidectomy from January 2015 to December 2017 were retrospectively analyzed.The patients were divided into 2 groups according to the preoperative tumor diameter:>5 mm group(88 cases)and≤5 mm group(171 cases);then according to the lymph node metastasis,the 2 groups were divided into non-lymph node metastasis sub-group and lymph node metastasis sub-group.The reason of lymph node metastasis was analyzed.Results There were no statistical difference in gender composition,age and combined Hashimoto thyroiditis rate between>5 mm group and≤5 mm group(P>0.05).The rates of T3-4 stage,N1a-1b stage and multifocal tumors in>5 mm group were significantly higher than those in≤5 mm group:34.1%(30/88)vs.18.7%(32/171),45.5%(40/88)vs.22.8%(39/171)and 39.8%(35/88)vs.22.8%(39/171),and there were statistical differences(P<0.05 or<0.01).In>5 mm group,lymph node metastasis sub-group had 40 cases,non-lymph node metastasis sub-group had 48 cases;the rate of T3-4 stage in lymph node metastasis sub-group was significantly higher than that in non-lymph node metastasis sub-group:55.0%(22/40)vs.16.7%(8/48),and there was statistical difference(P<0.01).In≤5 mm group,lymph node metastasis sub-group had 39 cases,and non-lymph node metastasis sub-group had 132 cases;the rate of T3-4 stage in lymph node metastasis sub-group was significantly higher than that in non-lymph node metastasis sub-group:51.3%(20/39)vs.9.1%(12/132),and there was statistical difference(P<0.01).In>5 mm group and≤5 mm group,there were no statistical difference in gender composition,age,combined Hashimoto thyroiditis rate and multifocal tumors rate between 2 sub-groups(P>0.05).Conclusions The clinical behavior of papillary thyroid microcarcinoma with diameter≤5 mm has a less aggressive nature compared to that>5 mm.Tumor capsular invasion or extra thyroidal
作者
姜雪
黄学忠
祖国
郭文斌
孔辉
Jiang Xue;Huang Xuezhong;Zu Guo;Guo Wenbin;Kong Hui(Department of Thyroid and Breast Surgery,Dalian Municipal Central Hospital Affiliated of DalianMedical University,Dalian 116033,China;Department of Gastroenterology Surgery,Dalian MunicipalCentral Hospital Affiliated of Dalian Medical University,Dalian 116033,China)
出处
《中国医师进修杂志》
2019年第3期193-196,共4页
Chinese Journal of Postgraduates of Medicine
关键词
甲状腺肿瘤
淋巴转移
疾病特征
回顾性研究
Thyroid neoplasms
Lymphatic metastasis
Disease attributes
Retrospective studies
