单侧甲状腺乳头状癌对侧中央区淋巴结转移的相关危险因素分析

Analysis of the risk factors of contralateral central lymph node metastasis in unilateral papillary thyroid carcinoma

目的探讨单侧甲状腺乳头状癌(uPTC)对侧中央区淋巴结(Cont-CLNs)转移的相关危险因素。方法回顾性分析2014年1月~2020年8月在遂宁市中心医院行甲状腺全切及双侧中央区淋巴结清扫的uPTC患者的临床资料,分析患者Cont-CLNs转移的临床危险因素。结果共纳入119例符合标准的患者,Cont-CLNs转移率为26.89%(32/119),单因素分析显示Cont-CLNs转移与患侧中央区淋巴结(Ipsi-CLNs)转移状态、性别、病变腺叶、肿瘤下缘距离甲状腺下缘距离、合并桥本氏甲状腺炎相关(P<0.05)。多因素Logistic回归分析表明,Ipsi-CLNs转移、肿瘤下缘距离甲状腺下缘距离≤10 mm及男性是对侧中央区淋巴结转移的独立危险因素(P<0.05)。结论uPTC患者为男性、伴有Ipsi-CLNs转移、肿瘤下缘距离甲状腺下缘距离≤10 mm等特征时应警惕Cont-CLNs转移,可考虑行Cont-CLNs清扫术。

Objective To explore the risk factors of contralateral central lymph nodes(Cont-CLNs)metastasis in unilateral papillary thyroid carcinoma(uPTC).Methods The clinical data were collected from the uPTC patients who had underwent total thyroidectomy and bilateral central lymphadenectomy in Suining City Central Hospital from January 2014 to August 2020,and were analyzed retrospectively.And the risk factors related to Cont-CLNs were analyzed.Results A total of 119 eligible patients were collected,the rate of Cont-CLNs metastasis was 26.89%(32/119).The univariate analysis showed that Cont-CLNs metastasis was related to the Ipsi-CLNs metastasis,gender,diseased glandular lobe,tumor size,the distance between the lower edge of tumor and the lower edge of thyroid and Hashimoto's thyroiditis(P<0.05).The result of Logistic regression model revealed that Ipsi-CLNs metastasis,the distance between the lower edge of tumor and the lower edge of thyroid≤10 mm and male were independent risk factors of Cont-CLNs metastasis(P<0.05).Conclusion Cont-CLNs dissection should be considered when unilateral thyroid papillary carcinoma is associated with high-risk features such as Ipsi-CLNs metastasis,the distance between the lower edge of tumor and the lower edge of thyroid≤10 mm and male.