甲状腺乳头状癌右侧喉返神经后方淋巴结转移的危险因素分析

Risk factors for lymph node posterior right recurrent laryngeal nerve metastasis of papillary thyroid carcinoma

目的:分析甲状腺乳头状癌(papillary thyroid carcinoma,PTC)右侧喉返神经后方淋巴结(lymph node posterior right recurrent laryngeal nerve,LN-prRLN)转移的相关危险因素。方法:回顾性分析我科2014年1月至2019年8月收治的424例行右侧或双侧甲状腺切除术的PTC病人临床病理资料,采用χ~2检验和Logistic回归模型分析LNprRLN转移的危险因素。结果:96例(22.64%)病人存在LN-prRLN转移。单因素分析结果显示,年龄、肿瘤直径、被膜侵犯、右侧Ⅵa区淋巴结转移与LN-prRLN转移相关(均P<0.001)。Logistic回归分析结果显示,肿瘤直径≥1 cm、被膜侵犯、右侧Ⅵa区淋巴结转移是LN-prRLN转移的独立危险因素(P均≤0.001)。结论:本研究显示PTC的LN-prRLN转移(22.64%)。当肿瘤直径≥1 cm、被膜侵犯、Ⅵa区淋巴结转移时,更应注重LN-prRLN清扫的彻底性。

Objective To investigate the risk factors for lymph node posterior right recurrent laryngeal nerve(LN-prRLN) metastasis of papillary thyroid carcinoma(PTC). Methods Clinicopathologic data of 424 patients with PTC who had right or bilateral thyroidectomy were analyzed retrospectively between January 2014 and August 2019 in our department. Risk factors for LN-prRLN metastasis were analyzed by χ~2 test and Logistic regression model. Results LN-prRLN metastasis had been detected in 96(22.64%) patients. Univariate analysis showed that the factors including age, tumor diameter, capsular invasion and right Ⅵa lymph node metastasis were significantly related with LN-prRLN metastasis(all P<0.001). It was shown by Logistic regression analysis that 3 factors of tumor diameter 1 cm and larger, capsular invasion and right Ⅵa lymph node metastasis were independent risk factors for LN-prRLN metastasis(all P≤0.001). Conclusions The rate of LN-prRLN metastasis was 22.64% in this study. It should be paid more attention to LN-prRLN dissection when tumor diameter 1 cm and larger, capsular invasion and right Ⅵa lymph node metastasis were found in PTC patients.