探讨分化型甲状腺癌围手术期循环血微转移相关因素分析

Correlative factors of preoperative circulatory blood micrometastasis in differentiated thyroid carcinoma

目的 探讨分化型甲状腺癌围手术期循环血微转移的发生情况及其影响因素.方法 随机选取本院2013年7月至2015年6月期间收治的分化型甲状腺癌患者164例,采用流式细胞术对其进行围手术期外周血微转移检查,并对其相关影响因素进行分析.结果 术前循环血微转移同淋巴结分期（x2=-4.622,P=0.032）和肿瘤大小（x2=4.429,P=0.035）之间存在明显相关性（P＜0.05）,而同肿瘤分化程度并无明显关系（x 2=2.023,P=0.155）;术后循环血微转移阳性仅同肿瘤的分化程度有关（x2=4.409,P=0.036）,同淋巴结分期（x2=1.218,P=0.270）和肿瘤大小（x2=0.980,P=0.322）并无明显相关性.结论 分化型甲状腺癌患者循环血微转移的发生与手术刺激、淋巴结分期和肿瘤大小之间存在密切关系,其中肿瘤分化程度是造成此类患者持续存在血微转移的重要因素.

Objective To investigate the incidence of preoperative circulatory blood micrometastasis in differentiated thyroid carcinoma and the relevant factors.Methods The clinical data of 164 thyroid carcinoma patients admitted into our hospital from July,2013 to June,2015 was randomly collected.Peripheral blood micrometastasis was checked with flow cytometry.The relevant factors of the micrometastasis were analyzed.Results The preoperative circulatory blood micrometastasis obviously correlated with lymph node staging （x2=-4.622,P=0.032） and tumor size （x 2=4.429,P=-0.035） but not with tumor differentiation （x2=2.023,P=-0.155）;the positivity of postoperative circulatory blood micrometastasis only correlated with tumor differentiation （x2=4.409,P=0.036〈0.05） but not with lymph node staging （x2=1.218,P=0.270） and tumor size （x2=0.980,P=0.322）.Conclusions The incidence of circulatory blood micrometastasis in preoperative thyroid carcinoma patients has close relationship with surgical stimulation,lymph node staging,and tumor size.While,the degree of tumor differentiation is an important factor in this kind of continuous blood mircrometastasis patients.