摘要
目的:研究甲状腺乳头状癌患者发现方式与临床病理特征的关系,探讨体检筛查是否会导致甲状腺乳头状癌的过度诊断。方法:回顾性分析3 398例甲状腺乳头状癌患者临床资料,根据患者主诉的疾病发现方式,将入组患者分为四组:体检组、颈部不适组、自检组、其他疾病意外发现组。通过单因素和多元逻辑回归分析甲状腺乳头状癌患者发现方式与临床病理特征的相关性。结果:单因素分析表明甲状腺乳头状癌患者发现方式与肿瘤病灶大小、是否侵犯包膜、是否有淋巴结转移以及淋巴结转移位置显著相关(P<0.05),而与病灶分布以及病灶的数目无关(P>0.05)。多元逻辑回归分析表明颈部不适组患者肿瘤病灶>1 cm的发生风险是体检组患者的1.626倍(OR=1.626,P=0.012),自检组患者肿瘤病灶> 1 cm的发生风险是体检组患者的2.245倍(OR=2.245,P <0.001);自检组患者肿瘤病灶侵犯包膜的发生风险是体检组患者的1.649倍(OR=1.649,P <0.001);自检组患者淋巴结转移的发生风险是体检组患者的1.642倍(OR=1.642,P <0.001);颈部不适组患者仅在中央区有淋巴结转移的发生风险是体检组患者的0.575倍(OR=0.575,P=0.044),在中央区以及颈侧区都有淋巴结转移的发生风险是体检组患者的1.803倍(OR=1.803,P=0.038);自检组患者仅在中央区有淋巴结转移的发生风险是体检组患者的0.283倍(OR=0.283,P <0.001),在中央区以及颈侧区都有淋巴结转移的发生风险是体检组患者的3.299倍(OR=3.299,P <0.001)。结论:健康体检有助于降低甲状腺乳头状癌患者肿瘤病灶增大、包膜侵犯以及淋巴结转移的风险,对甲状腺乳头状癌早发现、早诊断、早治疗有重要的作用,值得继续大力推广。
Objective:To investigate the relationship between the discovery ways of patients with papillary thyroid carcinoma and clinicopathologic features and investigate whether physical examination screening could lead to over-diagnosis of these patients.Methods:The clinical data of 3 398 patients with papillary thyroid carcinoma were analyzed retrospectively.According to the discovery ways of patients with papillary thyroid carcinoma, the patients were divided into physical examination group, neck discomfort group, self-examination group, accidental discovery group by other diseases.The correlation between the discovery ways of patients with papillary thyroid carcinoma and clinicopathological features was analyzed by univariate analysis and multiple Logistic regression.Results:Univariate analysis showed that the discovery ways of patients with papillary thyroid carcinoma were significantly correlated with tumor lesion size, invasion of capsule, lymph node metastasis and location of lymph node metastasis(P<0.05),but not with lesion distribution and number of lesion(P>0.05).Multiple Logistic regression analysis indicated that the risk of tumor lesions >1 cm in the neck discomfort group was 1.626 times higher than that in the physical examination group(OR=1.626,P=0.012),and the risk of tumor lesions >1 cm in the self-examination group was 2.245 times higher than that in the physical examination group(OR=2.245,P<0.001).The risk of tumor lesions invading the capsule in the self-examination group was 1.649 times higher than that in the physical examination group(OR=1.649,P<0.001).The risk of lymph node metastasis in the self-examination group was 1.642 times higher than that in the physical examination group(OR=1.642,P<0.001).The risk of lymph node metastasis only in the central area in the neck discomfort group was 0.575 times higher than that in the physical examination group(OR=0.575,P=0.044),and the risk of lymph node metastasis in both the central and lateral cervical areas in the neck discomfort group was 1.803 times hi
作者
张彩霞
延常姣
郭丝锦
ZHANG Caixia;YAN Changjiao;GUO Sijin(Department of Thyroid,Breast and Vascular Surgery,Xijing Hospital,Air Force Medical University,Shaanxi Xi'an 710032,China)
出处
《现代肿瘤医学》
CAS
北大核心
2022年第20期3683-3687,共5页
Journal of Modern Oncology
基金
陕西省社会发展攻关计划项目(编号:2016SF-298)。
关键词
甲状腺乳头状癌
甲状腺肿瘤
病理特征
健康体检
papillary thyroid carcinoma
thyroid neoplasm
pathological features
health examination
