甲状腺微小乳头状癌侧颈部淋巴结转移相关危险因素分析

Risk factors of lateral cervical metastasis in papillary thyroid microcarcinoma

目的分析甲状腺微小乳头状癌侧颈部淋巴结转移相关危险因素,为更好的制定手术范围提供理论基础。方法回顾性分析2012年1月至2013年1月行甲状腺手术及侧颈部淋巴结清扫术,术后病理检查证实甲状腺癌微小乳头状癌患者120例。回顾分析患者侧颈部淋巴结转移、性别、年龄、肿瘤大小、中央区淋巴结转移等因素之间的关系。结果 120例患者总体转移率为73例(60.8%)。单因素分析显示,患者侧颈部淋巴结转移与肿瘤大小、肿瘤播散、腺体外侵犯、原发肿瘤位置及中央区淋巴结转移等有统计学差异,而与性别、年龄、是否存在沙砾体、癌灶数目及病灶单、双侧无统计学差异。多因素分析中,仅有肿瘤位置及中央区淋巴结转移与侧颈部淋巴结转移相关明显。结论甲状腺乳头状癌出现中央区或侧颈部淋巴结转移极为常见,在当原发肿瘤位于甲状腺中部或下极及中央区淋巴结转移时,在术前或术中,应仔细评估侧颈部淋巴结,如出现可疑淋巴结转移应积极行侧颈部淋巴结清扫术。

Objective To analysis the risk factors of lateral cervical node metastasis （LNM） in papillary thyroid microcarcinoma （PTMC）. Methods Clinical data of 120 patients with PTMC admitted and treated in Zhejiang Provincial Cancer Hospital from 2012 to 2013 were retrospectively reviewed. SPSS 21.0 was used to statistically analyze the clinical information and the risk factors of LNM. Results Among 120 patients, 73 patients （60.8%） presented LNM. Univariate analysis showed that tumor size, tumor spread, extrathyroidal invasion, primary tumor location and central compartment metastasis （CNM） were associated with LNM. Multivariate analysis showed that primary location and CNM were independent risk factors of LNM. Conclusion lymph node metastases are very common in PTMC, and the location of primary tumor and central compartment metastasis are the risk factors of lateral lymph node metastasis.