摘要
目的:研究甲状腺乳头状癌(PTC)合并桥本甲状腺炎(HT)患者的临床病理特征及颈部淋巴结转移影响因素。方法:选取2016年1月~2020年12月于广州医科大学附属第四医院院诊治疑似PTC合并HT患者119例为研究对象,术后经病理确诊PTC合并HT患者47例为研究组,PTC未合并HT患者72例为对照组,同期纳入50例单纯HT患者作为HT组。回顾性观察分析研究组和对照组患者的性别、年龄、肿瘤纵横比、survivin及Ki-67阳性表达率、血清TgAb及TPOAb水平等临床病理特征,并比较3组患者超声特征,同时分析PTC合并HT患者发生颈部淋巴结转移的影响因素。结果:研究组的女性比例、肿瘤纵横比、颈部中央区淋巴结转移比例及肿瘤外侵比例均明显高于对照组(均P<0.05)。3组患者在超声检查的癌结节边界、形态、内部回声、钙化情况和血流信号等比较差异有统计学意义(均P<0.05)。研究组患者血清TgAb及TPOAb水平均高于对照组(均P<0.05)。多因素logistic回归分析结果显示,肿瘤纵横比、性别、肿瘤外侵、TgAb和TPOAb是PTC合并HT患者患者发生中央区淋巴结转移的独立危险因素(P<0.05)。结论:PTC合并HT患者有着较高的淋巴结转移和肿瘤外侵症状,同时发现较高的自身抗体水平及较大的肿瘤纵横比也是PTC合并HT患者出现颈部淋巴结转移的影响因素,对此类患者治疗及预后评估有着重要指导意义。
Objective:To investigate the clinicopathological features and influencing factors of cervical lymph node metastasis in papillary thyroid carcinoma(PTC)complicated with Hashimoto s thyroiditis(HT).Methods:Included were 119 patients with suspected PTC and HT diagnosed and treated in the Fourth Affiliated Hospital of Guangzhou Medical University between January 2016 and December 2020.Of these,post-surgical pathology showed that there were 47 patients with PTC and HT(study group)and 72 with PTC but not HT(control group).A contemporary cohort of 50 patients with HT alone were recruited as the HT group.The study and the control groups were retrospectively analyzed for clinicopathological features,including gender,age,tumor aspect ratio,positive expression of survivin and Ki-67,serum TgAb and TPOAb levels.The ultrasound characteristics were compared among the three groups.Influencing factors of cervical lymph node metastasis in PTC complicated with HT were analyzed.Results:The proportion of female gender,tumor aspect ratio,proportions of lymph node metastasis in the cervical central compartment and extrathyroidal invasion in the study group were significantly higher than those in the control group(all P<0.05).On ultrasound,significant differences were noted in the boundary of cancer nodule,morphology,internal echo texture,calcification and blood flow among the three groups of patients(all P<0.05).The serum levels of TgAb and TPOAb in the study group were higher than those in the control group(all P<0.05).Multivariate logistic regression analysis showed that tumor aspect ratio,gender,extrathyroidal invasion,TgAb and TPOAb levels were independent risk factors for lymph node metastasis of cervical central compartment in patients with PTC and HT(P<0.05).Conclusion:PTC patients with HT are more likely to have symptoms of lymph node metastasis and extrathyroidal invasion.Meanwhile,higher levels of autoantibodies level and larger tumor aspect ratio are also influencing factors of cervical lymph node metastasis in these patient
作者
邱丽浈
邱友燕
陈晓珠
刘钰君
吴共发
Qiu Lizhen;Qiu Youyan;Chen Xiaozhu;Liu Yujun;Wu Gongfa(Health Management Center;Department of Endocrinology;Department of Pathology,Fourth Affiliated Hospital of Guangzhou Medical University,Guangzhou 511300,China)
出处
《广州医科大学学报》
2022年第3期70-75,共6页
Academic Journal of Guangzhou Medical University
基金
广州市科技计划项目(201804010043)。
关键词
甲状腺乳头状癌
桥本甲状腺炎
临床病理特征
颈部淋巴结转移
Papillary thyroid carcinoma
Hashimoto s thyroiditis
Clinicopathological features
Cervical lymph node metastasis
