摘要
目的 分析甲状腺微小乳头状癌（ＰＴＭＣ）的临床病理特征，并探讨与中央区淋巴结转移的相关风险因素。方法 回顾性分析８５５例经病理证实的单侧ＰＴＭＣ患者的临床病理资料。结果 ８５５例中，ＰＴＭＣ的中央区淋巴结转移率为２１．９％（１８７／８５５）。单因素分析显示男性患者、年龄＜４５岁、癌灶＞５ｍｍ、包膜侵犯、多灶性及腺内播散的ＰＴＭＣ患者中央区淋巴结转移率显著增加（３１．４％比１９．５％，χ２＝１１．４２９，Ｐ＝０００１；２９３％比１５．９％，χ２＝２２．４１６，Ｐ＝０．０００；３０．０％比１４．３％，χ２ ＝３０．６６９，Ｐ＝０．０００；２９．４％比１６．８％，χ２ ＝１９２３３，Ｐ＝０．０００；３０．０％比１９．９％，χ２＝８．２０５，Ｐ＝０．００４；４２．９％比２１．３％，χ２＝５．５４９，Ｐ＝０．０１８）。多因素分析显示性别（男性）（９５％ＣＩ：０．３８０～０．８３４）、年龄（＜４５岁）（９５％ＣＩ：０．３４９～０．６９３）、癌灶大小（＞５ｍｍ）（９５％ＣＩ：１．４５０～３．０６０）、包膜侵犯（９５％ＣＩ：１．０７８～２．２２９）、多灶性（９５％ＣＩ：１．０２４～２．３７３）是ＰＴＭＣ中央区淋巴结转移的独立风险因素。结论 男性患者、年龄＜４５岁、癌灶＞５ｍｍ、包膜侵犯、癌多灶的ＰＴＭＣ患者其中央区淋巴结转移率较高，建议对其行预防性中央区淋巴结清扫术。
Objective Toinvestigatetheclinicalfeaturesofpapillarythyroidmicrocarcinoma（PTMC）andtheriskfactorsofcentrallymphnodemetastasis（CLNM）inPTMCpatients.Methods Theclinicaldataof855patientswithPTMCwhounderwentprophylacticcentrallymphnodedissectionwereretrospectivelyreviewed.Results Inthepresentstudy,therateofCLNMwas21.9%（187/855）inPTMCpatients.Intheunivariateanalysis,theincidenceofCLNMwassignificantlyhigherinmalepatients,age〈45years,tumorsize〉5mm,capsularinvasion,multipletumorandintracapsularspread（31.4% vs.19.5%,χ2=11.429,P=0.001;29.3% vs.15.9%,χ2=22.416,P=0.000;30.0% vs.14.3%,χ2=30.669,P=0.000;29.4% vs.16.8%,χ2=19.233,P=0.000;30.0% vs.19.9%,χ2=8.205,P=0.004;42.9% vs.21.3%,χ2=5.549,P=0.018,respectively）.Multivariateanalysisshowedthatmalegender,age〈45years,tumorsize〉5mm,multiplicityandcapsularinvasionwereindependentriskfactorsforCLNMinPTMCpatients（95% CI：O. 380 - O. 834,0. 349 - O. 693,1. 450 - 3. 060, 1. 078 - 2. 229,1. 024 - 2. 373,respectively）. Conclusion A routine prophylactic central lymph node dissection should be considered particularly in male PTMC patients with age 〈 45 years, tumor size 〉 5 mm, capsular invasion and tumor multiplicity.
出处
《中国基层医药》
CAS
2017年第24期3690-3693,共4页
Chinese Journal of Primary Medicine and Pharmacy
基金
浙江省自然科学基金项目（LY15H160008）
关键词
甲状腺肿瘤
淋巴结
危险因素
Thyroid neoplasms
Lymph node
Risk factors
