甲状腺微小癌Ⅵ区淋巴结转移相关因素研究

Factors Related to Metastasis of Central Compartment Lymph Nodes(Level Ⅵ) in Patients with Papillary Thyroid Microcarcinoma

目的探讨临床颈侧区淋巴结阴性(cN0)甲状腺乳头状微小癌(PTMC)中央区淋巴结转移相关的临床病理因素。方法回顾分析2007年1月-2010年1月初治的109例颈侧区cN0 PTMC患者的资料,探讨与PTMCⅥ区淋巴结转移相关的临床病理因素。结果 109例PTMC患者中Ⅵ区淋巴结转移率为31.2%(34/109)。单因素分析发现肿瘤最大径(≥5 mm)、多发病灶与PTMCⅥ区淋巴结转移显著相关(P<0.05);Logistic回归模型多因素分析显示肿瘤最大径(≥5 mm)、多发病灶为PTMCⅥ区淋巴结转移的独立危险因素(P<0.05)。结论 PTMC中原发灶大小(≥5 mm)、多发病灶患者Ⅵ区淋巴结转移率显著升高。对于这两类PTMC患者需常规行Ⅵ区淋巴结清扫。

Objective To analyze the related elinicopathologic factors of central compartment lymph node metastasis（ CCLNM ） in clinically node negative neck（cN0） patients with thepapillary thyroid microcarcinoma（ PTMC ）. Methods The clinical data of one hundred and nine（ 21 males and 88 female） eN0 patients with FFMC undergoing the thyroid lobectomy or total thyroideeto- my and central compartment lymph node dissection from Jan. 2007 to Jan. 2010 were analyzed retrospectively. The clinicopathologic factors which related to CCLNM,such as age,sex, tumor size, tumor capsule, multifocality and mierocalcification,were analyzed. Results CCLNM was found in 34 of the 109 patients （31.2% ）. Tumor size （ ≥ 5 mm） , muhifocality were found signifi- cantly related to CCLNM metastasis in univariate analysis （ P 〈 0.05 ）. The multivariate linear regression analysis showed that tumor size（ ≥ 5 ram） and muhifocality were the independent risk factors （P 〈 0.05 ）. Conclusion CCLNM occurs more frequently in the PTMC patients with Tumor size（≥5 mm） and muhifocality. The routine ipsilateral level VI lymph node dissection should be performed in patients with those risk factors.