摘要
目的探讨T1a期单灶性甲状腺乳头状癌(PTC)中央区淋巴结转移(CLNM)与临床病理特征、超声特征及淋巴结清扫数量的相关性,以及CLNM发生的危险因素。方法回顾性分析唐山市协和医院2017年1月至2021年5月收治的218例经手术治疗的T1a期单灶性PTC患者资料,根据CLNM情况分为CLNM阳性组和CLNM阴性组,记录两组患者的年龄、性别、术前超声特征、病理类型、淋巴结清扫数量及转移数量。采用logistic回归分析CLNM的危险因素。结果218例患者中,CLNM阳性组71例(32.6%),CLNM阴性组147例(67.4%)。CLNM阳性组和阴性组患者间年龄、肿瘤长径、甲状腺被膜是否被侵犯、肿瘤是否有血流及淋巴结清扫数量比较,差异均有统计学意义(均P<0.05);性别、肿瘤边界是否清晰、肿瘤形态、肿瘤纵横比、肿瘤是否钙化、有无结节性甲状腺肿、有无桥本甲状腺炎比较,差异均无统计学意义(均P>0.05)。多因素二元logistic回归分析显示,年龄<55岁(OR=2.995,95%CI 1.228~7.307)、肿瘤侵犯甲状腺被膜(OR=5.297,95%CI 2.494~11.248)及淋巴结清扫数量≥6枚(OR=4.085,95%CI 2.059~8.104)是CLNM的独立危险因素(均P<0.05)。结论年龄<55岁、肿瘤侵犯甲状腺被膜的T1a期单灶性PTC患者更容易发生CLNM,足量的淋巴结清扫数量可得到更准确的CLNM率。
Objective To investigate the correlation of central compartment lymph node metastasis(CLNM)in stage T1a solitary papillary thyroid carcinoma(PTC)with the clinicopathological characteristics,sonographic features and the number of lymph node dissection,and to analyze the risk factors of CLNM.Methods The data of 218 patients with stage T1a solitary PTC who underwent thyroid cancer surgery from January 2017 to May 2021 in Tangshan Union Medical College Hospital were retrospectively analyzed.All patients were divided into CLNM positive group and CLNM negative group according to CLNM.The age,gender,preoperative sonographic features,pathological type,the number of lymph node dissection and the number of metastasis were recorded.Logistic regression was used to analyze the risk factors of CLNM.Results Among 218 patients,there were 71 cases(32.6%)in CLNM positive group and 147 cases(67.4%)in CLNM negative group.There were statistically significant differences in age,tumor diameter,capsular invasion in thyroid or not,tumor blood supply or not,and the number of lymph node dissection between two groups(all P<0.05).There were no statistically significant differences in gender,clear tumor boundary or not,tumor shape,tumor aspect ratio,calcification,nodular goiter and Hashimoto's thyroiditis or not(all P>0.05).Multivariate binary logistic regression analysis showed that age<55 years(OR=2.995,95%CI 1.228-7.307),capsular invasion in thyroid(OR=5.297,95%CI 2.494-11.248)and the number of lymph node dissection≥6(OR=4.085,95%CI 2.059-8.104)were independent risk factors of CLNM(all P<0.05).Conclusions Patients with stage T1a solitary PTC,age<55 years and capsular invasion in thyroid are prone to CLNM;sufficient number of lymph node dissection can get more accurate CLNM rate.
作者
王刚
张岩
李云川
李强
董亚男
Wang Gang;Zhang Yan;Li Yunchuan;Li Qiang;Dong Yanan(Department of General Surgery,Tangshan Union Medical College Hospital,Tangshan 063000,China;Department of Ultrasonography,Tangshan Union Medical College Hospital,Tangshan 063000,China)
出处
《肿瘤研究与临床》
CAS
2023年第5期371-375,共5页
Cancer Research and Clinic
关键词
乳头状甲状腺癌
危险因素
超声检查
中央区淋巴结转移
Thyroid cancer,papillary
Risk factors
Ultrasonography
Central compartment lymph node metastasis
