94例甲状腺微小乳头状癌颈部淋巴结转移的影响因素分析

Risk factors for cervical lymph node metastasis of 94 cases of papillary thyroid microcarcinoma

目的:回顾性研究甲状腺微小乳头状癌颈部淋巴结以及颈部中央区淋巴结转移的相关影响因素。方法:收集2019年1月至2021年5月南京医科大学附属明基医院收治的94例甲状腺微小乳头状癌患者的临床资料,分析其性别、年龄、肿瘤数量、肿瘤位置、多灶性、被膜侵犯、血流信号、肿瘤侧别、肿瘤钙化、肿瘤纵横比、促甲状腺素激素、淋巴细胞性甲状腺炎、患者文化程度、病程与颈部淋巴结、颈部中央区淋巴结转移的相关性。结果:颈部淋巴结转移率为47%(44/94),经单因素分析,性别、年龄、被膜侵犯是甲状腺微小乳头状癌颈部淋巴结转移的危险因素(P<0.05);Logistic回归分析结果显示,男性和被膜侵犯是甲状腺微小乳头状癌颈部淋巴结转移的危险因素(P<0.05)。颈部中央区淋巴结转移率为33%(31/94),经单因素分析,性别、被膜侵犯是甲状腺微小乳头状癌颈部中央区淋巴结转移的危险因素(P<0.05);Logistic回归分析结果显示,男性和被膜侵犯是甲状腺微小乳头状癌颈部中央区淋巴结转移的危险因素(P<0.05)。结论:建议对有被膜侵犯的男性甲状腺微小乳头状癌患者进行预防性淋巴结清扫,降低因肿瘤复发而行再次手术的风险。

Objective:A retrospective study was conducted on the factors influencing cervical lymph node metastasis and central lymph node metastasis of papillary thyroid microcarcinoma.Methods:Clinical data of 94 patients with papillary thyroid microcarcinoma admitted to the Affiliated BenQ Hospital of Nanjing Medical University from January 2019 to May 2021 were collected.The correlations between gender,age,tumor number,tumor location,multifocal,capsule invasion,blood flow signal,tumor side,tumor calcification,tumor aspect ratio,thyrotropin hormone,lymphocytic thyroiditis,degree of education,course of the disease,cervical lymph node metastasis and central lymph node metastasis were analyzed.Results:The rate of cervical lymph node metastasis was 47%(44/94).According to univariate analysis,sex,age and capsular invasion were risk factors for cervical lymph node metastasis of papillary thyroid microcarcinoma(P<0.05).Logistic regression analysis showed that male and capsular invasion were risk factors for cervical lymph node metastasis of papillary thyroid microcarcinoma(P<0.05).The rate of cervical central lymph node metastasis was 33%(31/94).Univariate analysis showed that gender and capsular invasion were risk factors for cervical central lymph node metastasis of papillary thyroid microcarcinoma(P<0.05).Logistic regression analysis showed that male and capsular invasion were risk factors for cervical central lymph node metastasis of papillary thyroid microcarcinoma(P<0.05).Conclusion:Prophylactic lymph node dissection is recommended for male patients with papillary thyroid microcarcinoma with capsule invasion to reduce the risk of reoperation due to tumor recurrence.