甲状腺微小乳头状癌手术疗效和中央区淋巴结转移高危因素分析

Analysis of operation efficacy and high risk factor of central compartmetn lymph node metastasis in papillary thyroid microcaicinoma

目的分析甲状腺微小乳头状癌(PTMC)手术疗效和中央区淋巴结转移高危因素。方法回顾性分析98例手术治疗的PTMC患者的临床资料。所有患者均行中央区淋巴结清扫术,根据中央区淋巴结有无转移,将患者分为转移组和无转移组,比较两组患者相关临床因素的差异。同时,分析术后并发症、肿瘤复发和转移情况。结果术后随访时间为1～8年,所有患者均健在。术后10例出现伴有口周或肢端麻木等症状的低钙血症,4例患者术后复发,其中3例患者术后2年内发现同侧颈部淋巴结肿大,1例在术后131I扫描中发现有肺转移。转移组患者年龄显著低于无转移组(P<0.05),肿瘤大小、被膜外侵犯比例和肿瘤位于上极比例显著高于无转移组(P<0.05)。结论外科手术是一种有效治疗PTMC患者的方法;患者年龄、肿瘤大小、肿块位于上极和侵犯被膜外组织与中央区淋巴结转移密切相关。

Objective To analyze the operation efficacy and high risk factor of central compartmetn lymph node metastasis in papillary thyroid microcaicinoma （PTMC）. Methods The clinical datas of 98 patients with surgery treatment PTMC were analyzed retrospectively. The central compartmetn lymph node dissection were performed. All patients were divided into metastasis group and non-metastasis group. The factors were compared between the two groups, and the clinical efficacy was ananlyzed. Results The follow up period was 1-8 years, all patient were survival. Ten patient with hypocalcemia accompanied by numbness and 4 patients with tumor metastases were found. Among of patients with tumor metastases, 3 patients were neck lymph nodes metastases and 1 patient was lung metastases. Compared with non-metastasis group, the age of metastasis group was lower （P 〈 0.05）, the tumor size, rate of violation capsule and rate of upper pole tumor were higher （P 〈 0.05）. Conclusion Surgery is an useful treatment to treat PTMC. Age of patient, tumor size, upper pole tumor and violation capsule are associated with central compartmetn lymph node metastasis.