138例男性多灶性甲状腺乳头状癌临床病理特征分析

Analysis of clinicopathological features of multifocal papillary thyroid carcinoma in 138 cases of male patients

目的分析讨论男性多灶性甲状腺乳头状癌患者的临床病理特征,为多灶性男性甲状腺乳头状癌患者的治疗提供新思路。方法回顾性分析2012-2016年本院肿瘤外科行手术治疗并经术后病理证实的多灶性甲状腺乳头状癌患者共788例的临床资料,分析比较男性和女性患者在年龄、肿瘤大小、癌灶数目以及淋巴结转移状态等临床因素的差异性。结果男性患者138例,女性患者650例。138例男性患者的平均年龄(43.58±13.62)岁,病灶分布在单侧65例(47.1%),双侧分布73例(52.9%);病灶数为两个的96例(69.6%),病灶数≥3个的42例(30.4%);肿瘤直径>1.0 cm的70例(50.7%),直径≤1.0 cm的68例(49.3%);其中合并淋巴结转移的105例(76.1%)。结论男性多灶性甲状腺癌患者的病灶数量多、年龄较轻,癌灶分布更趋向于双侧分布,同时更易侵犯包膜。而年龄>45岁、肿瘤直径>1 cm、双侧多灶,包膜侵犯更倾向于发生颈部淋巴结转移,尤其是中央区淋巴结转移。且随着癌灶数的增加,中央区及侧区淋巴结转移率明显增加。

Objective To analyze and discuss the clinicopathological characteristics of male multifocal papillary thyroid carcinoma,and to provide a new way for the treatment of it.Methods The clinical data of 788 patients,with multifocal papillary thyroid cancer and received operation in the first affiliated hospital of Bengbu medical college from 2012 to 2016 and confirmed by postoperative pathology,were analyzed retrospectively.The differences of clinical factors such as age,tumor size,number of tumor foci and lymph node metastasis between male and female patients were compared.Results There were 138 male patients and 650 female patients.The average age of 138 male patients was(43.58±13.62)years old.65(47.1%)of 138 male patients with unilateral tumors and the other 73(52.9%)with bilateral tumors.96(69.6%)of them had two lesions and 42(30.4%)of them had more than three lesions.Tumor diameter was more than 1.0cm in 70(50.7%)of them and 68(49.3%)had a tumor diameter equal to or less than 1.0 cm.105(76.1%)of them presented to have lymph node metastasis.Conclusions Male patients with multifocal thyroid cancer presents to have the features that including numerous lesions,young in age,the distribution of tumor tends to be bilateral,and it is more likely to invade the capsule.A patient whose age over 45 years old,the tumor diameter is more than 1 cm,and there are multiple lesions on both sides,the invasion of the capsule is more likely to cause cervical lymph node metastasis,especially in the central region.With the increase of the number of cancer foci,the lymph node metastasis rate in the central and lateral areas increased significantly.