颈侧淋巴结阴性甲状腺乳头状微小癌中央区淋巴结转移临床病理分析

The clinical pathology analysis of papillary thyroid microcarcinoma with clinically node-negative sides of neck stage lymph node metastasis

目的 探讨颈侧淋巴结阴性（cN0）甲状腺乳头状微小癌（PTMC）中央区淋巴结转移相关临床病理因素.方法 分析136例cN0PTMC患者的临床资料,并采用PCR方法对其石蜡包膜组织检测BRAFV600E基因突变.结果 136例PTMC患者中央区淋巴结转移率为38.2％（52/136）,BRAFV600E基因突变率44.9％（61/136）.单因素分析显示中央区淋巴结转移与BRAFV600E基因突变、包膜侵犯有关（P＜0.05）,与肿瘤直径的相关性接近显著水平（P=0.057）.多因素回归分析显示,BRAFV6600E基因突变、包膜侵犯是影响中央区淋巴结转移的独立因素（P＜0.05）.结论 对于BRAFV600E基因突变、包膜侵犯者,应该常规清扫中央区淋巴结.

Objective To investigate the clinical pathological factors of papillary thyroid microcarcinoma （PTMC） with clinically node-negative sides of neck stage central lymph node metastasis.Methods Analysis of 136 cases of cNo stage of PTMC of clinical and pathological data,and using the PCR method for the detection of BRAFV600E mutation in the paraffin coated tissue.Results One hundred and thirty-six cases with PTMC lymph node metastasis rate was 38.2％ （52/136）,BRAFV600E mutation rate was 44.9％ （61/136）.Single factor analysis showed that the lymph node metastasis was related with BRAFV600E mutation and capsular invasion （P＜ 0.05）.The size of the tumor was close to significant level （P=0.057）.Multiple regression analysis showed that BRAFV600E mutation and capsular invasion were independent factors for affecting the central lymph node metastasis （P ＜ 0.05）.Conclusion The routine central lymph node dissection should be performed in patients with BRAFV600E mutation and tumor invasion.