甲状腺乳头状癌颈部淋巴结转移特征对远处转移的预测价值

The value of nodal metastatic characteristics in predicting the distant metastasis of papillary thyroid carcinoma

目的探讨颈部淋巴结转移特征预测甲状腺乳头状癌（papillary thyroid carcinoma，PTC）患者发生远处转移的临床价值。方法收集2006年1月至2011年12月符合纳人标准的PTC患者1408例，分析颈部淋巴结的转移部位、转移个数以及转移灶大小等与远处转移的相关性。结果中位随访时间7．8年，46例患者出现远处转移。侧颈区淋巴结转移个数≥7、淋巴结转移灶≥1．15cm，或者总淋巴结转移个数≥9时，具有较高的发生远处转移风险；具备上述淋巴结特征的高风险组具有较低的10年无远处转移生存率（78．7％比98％，χ^2=122．941，P〈0．01）及较短的无远处转移生存时间（99．2个月比122．5个月,χ^2=122．941，P〈0．01）。结论PTC侧颈区淋巴结转移是发生远处转移的独立危险因素。

Objective To explore tile clinical value of nodal metastatic characteristics in predicting the distant metastasis of papillary thyroid carcinoma （PTC）. Methods A total of 1 408 PTC patients who met the inclusion criteria and received initial thyroidectomy at our department from January 2006 to December 2011 were enrolled in this study. Results After a median follow-up time of 7. 8 years, distant metastases developed in 46 patients. Patients with lateral neck lymph node metastasis ≥7, individual size of lateral neck lymph node metastasis ≥ 1.15 cm and the total number of cervical lymph node metastasis ≥ 9 were prone to higher risk of distant metastasis; the high risk group had a lower 10-year distant metastasis-free survival （78.7% vs. 98% , χ^2 = 122. 941 ,P 〈0. 01 ） and a shorter distant metastasis-free survival time （99. 2 M vs. 122. 5 M, χ^2 = 122. 941, P 〈 0. 01 ）. Conclusions Lateral lymph node metastasis is an independent risk factor for distant metastasis in PTC patients.