cN_0期甲状腺乳头状癌中央区淋巴结转移的影响因素分析

Risk Factors of Central Lymph Node Metastasis in Papillary Thyroid Carcinoma of cN_0 Staging

目的 探索c N0期乳头状甲状腺癌（PTC）中央区淋巴结转移（CLNM）的危险因素。方法 回顾性分析2014年3～7月期间广东省人民医院收治的行预防性中央区淋巴结清扫（p CND）的94例c N0期PTC患者的临床病理资料。结果 术后经病理学检查证实,94例患者发生CLNM 43例（45.7%）。多因素分析结果表明,年龄〈45岁、B超示病灶靠近前方、肿瘤直径〉2 cm、包膜外侵及p CND清扫淋巴结数〉3枚患者的CLNM发生率较高（P〈0.05）。结论 年龄〈45岁、B超示病灶靠近前方及肿瘤直径〉2 cm均是c N0期PTC患者发生CLNM的高危因素,当具备上述某项或某几项危险因素时,可行p CND。

Objective To evaluate the risk factors for central lymph node metastasis （CLNM） in papillary thyroid carcinoma （PTC） of cN0 staging. Methods Clinical data of 94 patients with cN0 PTC in Guangdong General Hospital who underwent thyroidectomy with prophylactic central node dissection （pCND） from March to July in 2014 were collected to analyze the risk factors of CLNM by using univariate and multivariate analysis methods. Results CLNM was found in 43 patients （45.7%）. Multivariate analysis results showed that, the CLNM rate of patients with age 〈45 years, tumor located in front of lobe by ultrasound, diameter of tumor 〉2 cm, capsular invasion, and total number of central lymph node dissected 〉3 were significantly higher （P〈0.05）. Conclusion Age 〈45 years, tumor located in front of lobe by ultrasound, and diameter of tumor 〉2 cm are the risk factors of CLNM in patients with cN0 PTC, pCND should be performed for patients with some of the above risk factors.