摘要
目的:探讨散发性甲状腺髓样癌(sporadic medullary thyroid carcinoma,sMTC)患者侧颈淋巴结转移的危险因素。方法:回顾性分析2011年2月至2017年3月期间就诊于天津医科大学肿瘤医院94例MTC患者的临床及超声特征资料,采用Fisher’s精确检验及Logistic回归分析侧颈淋巴结转移的危险因素。结果:单因素Logistic分析显示,性别(F=5.234,P=0.022)、术前降钙素水平(F=21.327,P<0.001)、最大径(F=5.875,P=0.015)、位置(F=6.088,P=0.014)、肿物性质(F=5.224,P=0.047)、形状(F=8.754,P=0.003)、边缘(F=15.971,P<0.001)均与侧颈区淋巴结转移有显著性差异;多因素分析显示男性、术前降钙素>319 pg/mL、位于上极、边缘不规则、低回声是影响MTC侧颈区淋巴结转移的独立危险因素(均P<0.05)。结论:男性、术前降钙素>319 pg/mL、位于上极、边缘不规则、低回声与MTC患者侧颈淋巴结转移显著相关,且随着危险因素个数的增多,发生侧颈淋巴结转移概率增加。
Objective: To investigate the risk factors of lateral cervical lymph node metastasis in patients with sporadic medullary thyroid carcinoma(sMTC). Methods: The clinical and ultrasonographic features of 94 patients with MTC treated in Tianjin Medical University Cancer Institute and Hospital from July 2009 to December 2011 were analyzed retrospectively. The risk factors for lateral cervical lymph node metastasis were analyzed using Fisher’s exact test and Logistic regression. Results: Single factor Logistic analysis showed that male sex(F=5.234, P=0.022), preoperative calcitonin level >319 pg/mL(F=21.327, P<0.001), maximum diameter >1.4 cm(F=5.875,P=0.015), upper pole location(F=6.088, P=0.014), pure solid type(F=5.224, P=0.047), irregular shape(F=8.754, P=0.003), and ill-defined margin(F=15.971, P<0.001) were risk factors for lateral cervical lymph node metastasis. Multifactor analysis showed that male sex, preoperative calcitonin level >319 pg/mL, upper pole location, ill-defined margin, and hypoechoic findings on ultrasound were independent risk factors for lateral cervical lymph node metastasis. Conclusions: MTC patients with three or more risk factors(male sex,preoperative calcitonin level >319 pg/mL, upper pole location, irregular edge, and hypoechoic findings on ultrasound) have a higher likelihood of developing lateral cervical lymph node metastasis, and thus, preventive side neck lymph node dissection should be considered.
作者
李树岭
候秀坤
董居来
李大鹏
赵敬柱
郑向前
高明
Shuling Li;Xiukun Hou;Julai Dong;Dapeng Li;Jingzhu Zhao;Xiangqian Zheng;Ming Gao(Department of Thyroid and Neck Tumor,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center of Cancer,Tianjin Key Laboratory of Cancer Prevention and Therapy,Tianjin's Clinical Research Center for Cancer,Tianjin 300060,China;Department of Oncology Surgery,Huanghua Orthopaedic Hospital,Hebei 061100,China)
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2019年第20期1032-1035,共4页
Chinese Journal of Clinical Oncology
关键词
甲状腺髓样癌
侧颈淋巴结转移
术前临床因素
超声影像特征
危险因素
medullary thyroid carcinoma(MTC)
lateral cervical lymph node
preoperative clinical factors
ultrasonographic features
risk factors