乌鲁木齐某三甲医院2017年-2019年甲状腺癌临床特征及颈部淋巴结转移危险因素分析

Analysis of Clinical Characteristics of Thyroid Cancer and Risk Factors of Cervical Lymph Node Metastasis in a Third-Grade A Hospital in Urumqi from 2017 to 2019

目的通过分析乌鲁木齐某三甲医院2017年-2019年甲状腺癌患者的临床特征,探寻颈部淋巴结转移的危险因素,为临床制定更合理的治疗方案提供数据依据。方法回顾性分析乌鲁木齐某三甲医院2017年1月1日-2019年12月31日期间544例甲状腺癌患者作为研究对象。收集甲状腺癌患者临床资料,归纳总结甲状腺癌临床特征,探究年龄、性别、病理分型、病灶数、病灶直径、超声检查结果、淋巴结肿大情况等对甲状腺癌淋巴结转移的影响。结果乌鲁木齐市某三甲医院2017年-2019年甲状腺癌患者分型以甲状腺乳头状癌为主,占比为58.33%~66.50%;不同分型甲状腺癌患者病灶数、肿瘤直径和颈部淋巴结转移情况分布差异具有统计学意义,P<0.05。单因素和多因素分析显示,病灶数(OR:3.846,95%CI:1.564~6.443)、肿瘤直径(OR:5.176,95%CI:3.541~9.402)、甲状腺包膜侵犯(OR:4.023,95%CI:2.363~7.679)是发生甲状腺癌颈部淋巴结转移的独立危险因素,P<0.05。结论甲状腺癌患者的肿瘤直径>1cm、双侧多灶,包膜侵犯更容易发生颈部淋巴结转移,病灶数量、大小、包膜侵犯均为淋巴结转移的独立危险因素。

Objective To analyze the clinical characteristics of patients with thyroid cancer in a tertiary hospital in Urumqi from 2017 to 2019, and the risk factors for cervical lymph node metastasis. Methods 544 patients with thyroid cancer from a third-grade a hospital in urumqi from January 1, 2017 to December 31, 2019 were retrospectively selected as the study subjects.The clinical data of patients with thyroid cancer were collected to summarize the clinical characteristics of thyroid cancer, and the effects of age, gender, pathological classification, number of lesions, diameter of lesions, ultrasonic examination results, and enlarged lymph nodes on lymph node metastasis of thyroid cancer were investigated. Results From 2017 to 2019, thyroid papillary carcinoma was dominant in a grade a hospital in Urumqi with 58.33%~66.50%. There were significant differences in the number of lesions, tumor diameter and distribution of cervical lymph node metastasis in patients with different thyroid cancer types(P<0.05). Univariate and multivariate analysis showed that the number of lesions(OR: 3.846, 95%CI: 1.564~6.443), tumor diameter(OR: 5.176, 95%CI: 3.541~9.402), thyroid capsule invasion(OR: 4.023, 95%CI:2.363~7.679) is an independent risk factor for cervical lymph node metastasis of thyroid cancer(P<0.05). Conclusion The tumor diameter of >1 cm and bilateral multiple foci were more likely to have cervical lymph node metastasis due to the involvement of the capsule for patients with TC, The number, size and involvement of the capsule were independent risk factors for lymph node metastasis.