3125例颈部非甲状腺肿物疾病多重分析

Analysis of 3125 Cases with Non-thyroidal Masses of the Neck

目的:对颈部非甲状腺肿物(Non-Thyrogenous Masses of the Neck,NTMN)进行新分区、大样本和多角度的综合分析总结。方法:选取相关病例3125例,首先进行NTMN的构成比例总结;其次分析研究新近的国际分区中各疾病的分布情况;进而分析总结NTMN疾病的性别、年龄等相关临床特征,对颈部隐源性转移癌(Unknown Primary Cervical Metastatic Carcinoma,UPCMC),多发结节型NTMN及结核性淋巴结炎等进行分析。结果:本研究共收集非甲状腺肿物疾病68类。转移性恶性肿瘤占恶性肿瘤性疾病的63.3%,原发灶在锁骨以上部位的转移癌占原发灶明确的转移癌的62.3%。在各分区中NTMN都有着较为明确的分布特征,如Ⅲ区23类疾病中,恶性淋巴瘤及转移癌最多见。UPCMC占转移癌的12.3%。多发结节型NTMN主要由恶性淋巴瘤、各类转移癌及结核性淋巴结炎等构成。结核性淋巴结炎中无结核中毒症状者占77.1%。结论:NTMN疾病构成复杂,表现多样,诊断较为困难,构成比例部分地支持了"80%规律",在各分区中均具有较为独特的疾病分布情况。而对于性别年龄比例、UPCMC、多发结节型NTMN、恶性淋巴瘤及结核性淋巴结炎等内容的总结均在不同程度上体现了本地区NTMN疾病发病的临床特点。本研究可以在多个层面为临床工作提供数据结论支持。

Objective： To systematically analyze and summarize the diagnosis of non-thyroidal mass of the neck （NTMN） by means of a new classification system using a large sample size. Methods： A total of 3125 NTMN cases were selected to determine the constituent ratio of NTMN. The distribution of various diseases was analyzed and investigated based on updated international classifications, and then research on related clinical features of the NTMN, such as sex and age etc., was conducted with a monographic analysis for unknown primary cervical metastatic carcinoma（UPCMC）, multinodular NTMN and tuberculous lymphadenitis. Results： Sixty-eight categories were included in the study. In the constituent ratio of all NTMN cases, the metastatic malignant tumors accounted for 63.3% of all cases with malignant disease, and the metastatic carcinoma cases with a primary focus at or above the collar bone accounted for 62.3% of all cases with malignant disease with a definite focus. Other results basically supported the ＂rule of 80%＂. There were definite characteristics of NTMN distributed in various sub-regions. For example, malignant lymphoma and metastatic carcinoma were most frequently seen in 23 categories of diseases of the sub-region Ⅲ. Monographic study showed that the UPCMC cases accounted for 12.3% of the metastatic cancer cases. Multiple NTMN was mainly composed of the lympho-, varied metastatic carcinomas and tubercular lymphadenitis, etc. In the cases of tuberculous lymphadenitis, that without tubercular toxic symptoms constituted 77.1% of the total. Conclusion： NTMN has a complex constitution and various manifestations, and its diagnosis is also difficult. The constituent ratio partially backed up ＂the rule of 80%＂. There are peculiar distributions of disease in the sub-regions. The summary of the contents, such as the sex-age rate, UPCMC, multiple and nodular NTMN, malignant lymphoma and tuberculous lymphadenitis, etc., reflects various clinical features including the onset of NTMN in the area.