摘要
目的探讨分化型甲状腺癌中央区淋巴结转移患者临床病理特征及转移危险因素,为临床治疗提供依据。方法选取广东省江门市中心医院2017年1月至2018年10月收治的分化型甲状腺癌患者200例。根据患者中央区淋巴结转移情况,将其分成转移组和未转移组。比较两组临床病理特征,包括性别、年龄、肿瘤直径、病变腺叶、肿瘤数量、TNM分期、包膜浸润、促甲状腺激素(TSH)、抗甲状腺球蛋白抗体(TG-Ab)、手术方式、血流分级、微钙化、抗甲状腺过氧化酶抗体(TPO-Ab)及病理类型。分析中央区淋巴结转移与临床特征的关系,利用logistic回归模型分析转移的危险因素。结果200例患者中,52例(26.0%)中央区淋巴结转移,148例(74.0%)无中央区淋巴结转移。转移组的肿瘤长径≥2 cm、包膜浸润、微钙化、血流分级Ⅲ级患者比例均较未转移组高,差异均有统计学意义[86.5%(45/52)比68.2%(101/148),40.4%(21/52)比16.9%(25/148),34.6%(18/52)比11.5%(17/148),23.1%(12/52)比7.4%(11/148),均P<0.05],两组间其他临床病理因素分层患者比例差异均无统计学意义(均P>0.05)。logistic回归模型分析提示,肿瘤长径≥2 cm(OR=1.424,95%CI 1.041~1.948,P=0.027)、包膜浸润(OR=3.541,95%CI 1.378~9.099,P=0.009)、微钙化(OR=4.058,95%CI 1.693~9.727,P=0.002)、血流分级Ⅲ级(OR=5.174,95%CI 2.148~12.463,P<0.01)是患者中央区淋巴结转移的独立危险因素。结论分化型甲状腺癌患者中央区淋巴结转移与肿瘤长径、包膜浸润、微钙化、血流分级相关,临床需引起重视。
Objective To investigate the clinicopathological characteristics and metastatic risk factors for patients with lymph node metastasis in central region of differentiated thyroid cancer,and to provide a basis for clinical treatment.Methods A total of 200 patients with differentiated thyroid cancer from January 2017 to October 2018 in Jiangmen Central Hospital of Guangdong Province were selected.According to the central lymph node metastasis,the patients were divided into metastasis group and non-metastasis group.The clinicopathological features of the two groups were compared,including gender,age,tumor diameter,lesion gland lobe,the number of tumors,TNM staging,capsular infiltration,thyroid stimulating hormone(TSH),anti-thyroglobulin antibody(TG-Ab),operation mode,blood flow grading,microcalcification,thyroid peroxidase antibody(TPO-Ab)and pathological type.The relationship between central lymph node metastasis and clinical characteristics was analyzed.The risk factors of central lymph node metastasis were analyzed by using logistic regression model.Results Of the 200 patients,52(26.00%)patients had central region lymph node metastasis and 148(74.00%)patients had no central region lymph node metastasis.The tumor diameter≥2 cm,capsule infiltration,microcalcification and gradeⅢblood flow in the metastasis group were all higher than those in the non-metastasis group,and the differences were statistically significant[86.5%(45/52)vs.68.2%(101/148),40.4%(21/52)vs.16.9%(25/148),34.6%(18/52)vs.11.5%(17/148),23.1%(12/52)vs.7.4%(11/148),all P<0.05].There were no statistically differences in the proportion of patients stratified by other clinicopathological factors(all P>0.05).Logistic regression model suggested that tumor diameter≥2 cm(OR=1.424,95%CI 1.041-1.948,P=0.009),capsular infiltration(OR=3.541,95%CI 1.378-9.099,P=0.009),microcalcification(OR=4.058,95%CI 1.693-9.727,P=0.002)and gradeⅢof blood flow(OR=5.174,95%CI 2.148-12.463,P<0.01)were independent risk factors for lymph node metastasis in central region.Conclusion Central lymph node metastasis in patients with differentiated thyroid cancer is related to tumor diameter,capsular infiltration,microcalcification and gradeⅢof blood flow,which should be paid more attention in clinic.
作者
王兴
李伟文
邵明涛
梁丽红
陈敏
徐波
Wang Xing;Li Weiwen;Shao Mingtao;Liang Lihong;Chen Min;Xu Bo(Department of Thyroid and Breast Surgery,Jiangmen Central Hospital,Guangdong Province,Jiangmen 529030,China;Department of Supervision and Inspection,Jiangmen Institute of Occupational Disease Control,Guangdong Province,Jiangmen 529000,China;Department of Electrophysiology,Jiangmen Central Hospital,Guangdong Province,Jiangmen 529030,China;Department of Thyroid Surgery,the First People's Hospital of Guangzhou,Guangdong Province,Guangzhou 510180,China)
出处
《肿瘤研究与临床》
CAS
2020年第7期493-497,共5页
Cancer Research and Clinic
