甲状腺乳头状微小癌颈侧区淋巴结转移危险因素的meta分析

Risk factors for lateral lymph node metastasis in papillary thyroid microcarcinoma:A systematic review and meta-analysis

目的对甲状腺乳头状微小癌(papillary thyroid microcarcinoma,PTMC)中颈侧区淋巴结转移(lateral lymph node metastasis,LLNM)的临床病理和超声特征危险因素进行了系统回顾和meta分析。方法数据库搜索研究PTMC中LLNM的临床病理和超声危险因素的相关研究,运用RevMan5.3软件分析PTMC中LLNM的临床病理和超声相关危险因素。结果15项研究共涉及46610名患者,综合分析显示,年龄小于45岁,男性患者,甲状腺外浸润,肿瘤多灶性,肿瘤>0.5cm,中心淋巴结转移,与包膜接触面积>25%,肿瘤钙化,上部肿瘤与PTMC中LLNM风险增加显著相关,而桥本氏甲状腺炎、实体瘤、肿瘤低回声等临床超声表现与PTMC的LLNM无显著相关性。结论我们的分析发现了与PTMC中LLNM相关的几个临床病理和超声相关因素,PTMC患者术后仍需要重视颈侧区淋巴结。

Objective The clinicopathological and ultrasound risk characteristics of lateral lymph node metastasis(LLNM)in papillary thyroid microcarcinoma(PTMC)were systematically reviewed.Methods Databases were used to search and study the clinical and ultrasound related risk factors of LLNM in PTMC,and Revman 5.3 software was used to analyze the clinical and ultrasound related risk factors.Results 15 studies involving 46610 patients met the final inclusion criteria.Comprehensive analysis showed that patients younger than 45 years old,male patients,extrathyroid invasion,multifocality,tumor diameter>0.5cm,central lymph node metastasis,>25%contact with thyroid capsule,tumor calcification,upper tumor were associated with increased risk of LLNM in PTMC.There was no significant correlation between LLNM and Hashimoto's thyroiditis,solid tumor,hypoechoic tumor.Conclusion Our analysis identified several clinicopathological and ultrasound factors associated with LLNM in PTMC.This finding highlights the need for careful and frequent lateral neck monitoring in high-risk PTMC patients.