甲状腺乳头状癌淋巴结转移影响因素的探讨

The investigation on the impact factors of lymphatic metastasis of thyroid papillary carcinoma

目的探讨甲状腺乳头状癌颈部淋巴结转移规律及影响因素,为淋巴结清扫指征及范围的选择提供参考依据。方法回顾分析我院2008年6月至2011年12月初次治疗的1667例甲状腺乳头状癌患者的临床信息及病理资料,总结颈部淋巴结转移规律及影响因素。结果性别、年龄、肿瘤数目、肿瘤大小、局部浸润对甲状腺乳头状癌颈部淋巴结转移具有重要影响,转移在男性、低龄、多灶、肿瘤直径较大及局部浸润的患者中较为多见。结论甲状腺乳头状癌在制定淋巴结清扫指证及范围时,除重视术前影像学检查及术中触诊外,应充分评估影响淋巴结转移的高危因素,制定更加个体化的清扫策略。

Objective to investigate the impact factors and rules of the lymphatic metastasis of thyroid papillary car- cinoma,and provide reference gist to the indications and range of lymph node dissection. Methods We analyzed the clinical and pathological information of 1667 patients who were diagnosed as thyroid papillary carcinoma at the initial treatment from June 2008 to December 2011 and summarized the rules and impact factors of cervical lymph node metas- tasis by a retrospective study. Results there existed significant impacts to cervical lymph node metastasis of thyroid pa- pillary carcinoma in gender, age, the size and number of tumors, and local invasion, and it occurred more commonly in patients with the factors of male,young,multifocal,large size and local invasion. Conclusion we should not only attach importance to the imageological diagnosis before the surgery, but atso fully assess the factors of cervical lymph node metastasis of thyroid papillary carcinoma and make up more individual surgical strategies when we set out the surgical range of eervieal lymph node dissection.