淋巴结转移率与甲状腺乳头状癌患者术后复发及预后的相关性

Correlation of lymph node metastasis rate with postoperative recurrence and prognosis in patients with thyroid papillary carcinoma

目的研究淋巴结转移率(lymph node metastatic rate,LR)与甲状腺乳头状癌(papillary thyroid carcinoma,PTC)患者术后复发及预后的相关性。方法回顾性分析2010年1月至2013年6月期间上海市第一人民医院宝山分院收治的62例PTC患者的临床病理资料。根据LR值分为低LR组(<25%,38例)、高LR组(≥25%,24例)。比较两组患者临床病理特点、术后复发及5年生存率,分析预后的影响因素。结果不同年龄、病灶数、病灶直径、TNM分期及淋巴结转移数的患者,LR值比较差异均有统计学意义(P均<0.05);低LR组术后复发低于高LR组(15.8%与41.7%),而5年生存率低LR组高于高LR组(92.1%与63.0%)(P均<0.05);多因素回归LR、TNM分期是PTC患者预后的独立危险因素,而年龄则是独立保护因素(HR分别为1.587、1.714、0.617,P均<0.05)。结论LR可作为PTC患者术后复发及预后独立评估指标之一。

Objective To explore the correlation of of lymph node metastasis rate (LR) with postoperative recurrence and prognosis in patients with thyroid papillary carcinoma (PTC).Methods From January 2010 to June 2013, the clinical data of sixty-two patients with PTC in Baoshan Branch, Shanghai First People′s Hospital were retrospectively analyzed.According to the LR, patients were divided into low LR(<25%) group(38 cases), high LR(≥25%) group (24 cases). The clinical pathological characteristics, postoperative recurrence and 5-year survival rate of the two groups was compared, and the influence factors of prognosis were analyzed.Results There was significant difference in LR among patients with different ages, numbers of lesions, lesion diameters, TNM stages and numbers of lymph node metastasis (P<0.05);compared with high LR group, the recurrence in low LR group was obviously reduced(15.8% vs.41.7%), and 5-year survival rate was significantly increased (92.1% vs.63.0%) (P<0.05). LR and TNM stage were the independent risk factors of prognosis in PTC patients, and age was independent protection factor (HR=1.587, 1.714, 0.617, P<0.05).Conclusion LR can be used as one of postoperative recurrence and prognosis evaluation indicators of PTC.