临床普外科电子杂志 ›› 2023, Vol. 11 ›› Issue (3): 8-.

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甲状腺乳头状癌患者中央区淋巴结转移相关危险因素分析

  

  1. 1. 应城市人民医院 普外科,湖北 应城 432400;2. 应城市人民医院 胃肠甲乳外科,湖北 应城 432400
  • 出版日期:2023-07-01 发布日期:2023-09-01

Risk factors and management strategies of central lymph node metastasis in patients with papillary thyroid carcinoma

  1. 1. General Surgical Oncology Department of Yingcheng People’s Hospital, Hubei Yingcheng 432400, China;  2.Gastrointestinal Nail and Breast Surgery Department of Yingcheng People's Hospital, Hubei Yingcheng 432400, China
  • Online:2023-07-01 Published:2023-09-01

摘要:

目的 本研究通过对甲状腺乳头状癌(papillary thyroid carcinoma,PTC) 患者相关临床资料进行回顾性分析,探讨影响PTC 中央区淋巴结转移(central lymph node metastasis,CLNM) 的危险因素。方法 收集2020 年7 月至2021 年7 月应城市人民医院首次行甲状腺手术并经病理证实为PTC 的161 例住院患者临床资料,根据患者是否发生CLNM 分为转移组(n=100)与非转移组(n=61)。对比两组性别、年龄等一般资料及术前超声影像学资料,对PTC 患者发生CLNM 的危险因素进行分析。结果 单因素分析显示,CLNM 与年龄、性别、超声检查肿瘤直径、微钙化及存在血流信号有关(P < 0.05),与肿瘤触诊结果、肿瘤数量等因素无关(P > 0.05)。多因素分析显示,年龄< 45 岁、男性、肿瘤直径> 1.0cm、超声显示瘤微钙化及肿瘤内部探及血流信号是PTC 患者发生CLNM 的危险因素。结论 男性、年龄< 45 岁、肿瘤大小> 1cm、微钙化及病灶内部血流信号患者发生CLNM 的风险更大,建议此类PTC 患者进行预防性中央区淋巴结清扫术。

关键词: 甲状腺乳头状癌, 中央区淋巴结转移, 危险因素

Abstract:

Objective This study retrospectively analyzed the clinical data of patients with papillary thyroid carcinoma (PTC) to explore the risk factors for central lymph node metastasis (CLNM) in the neck of PTC. Method The clinical data of 161 hospitalized patients who underwent thyroid surgery for the first time and were pathologically confirmed as PTC in Yingcheng People's Hospital from July 2020 to July 2021 were collected. The patients were divided into metastasis group and non metastasis group according to whether they had CLNM. Compare general information such as gender, age, and preoperative ultrasound imaging data between two groups to analyze the risk factors for CLNM in PTC patients. Result Univariate analysis showed that CLNM was associated with age, gender, ultrasound examination of tumor diameter, microcalcification, and presence of blood flow signals (P< 0.05), but not with factors such as tumor palpation results and tumor number (P > 0.05). Multivariate analysis showed that age<45 years old, male, tumor diameter > 1.0cm, ultrasound display of tumor microcalcification, and detection of blood flow signals within the tumor are risk factors for CLNM in PTC patients. Conclusion Men, age < 45 years old, tumor size > 1cm, microcalcifications, and internal blood flow signals within the lesion have a higher risk of developing CLNM. It is recommended that such PTC patients undergo preventive central lymph node dissection.

Key words: Papillary thyroid carcinoma, Central lymph node metastasis, Risk factor analysis