甲状腺乳头状癌颈部淋巴结转移特征及相关影响因素研究

Study on the Characteristics of Cervical Lymph Nodes in Thyroid Papilloma

目的探讨甲状腺乳头状癌(PTC)颈部淋巴结转移特征及相关影响因素。方法96例PTC患者作为研究对象。统计PTC患者颈部淋巴结转移情况,并收集患者临床资料,依据是否存在中央区、颈侧区淋巴结转移分组,分析PTC颈部淋巴结转移的影响因素。结果96例PTC患者中颈侧淋巴结转移28例(29.17%),中央区淋巴结转移42例(43.75%),差异有统计学意义(P<0.05);年龄<45岁、男性、多发灶、肿瘤直径>1.0 cm、侵及被膜均是颈侧区淋巴结转移的独立危险因素;年龄<45岁、男性、多发灶、肿瘤直径>1.0 cm、侵及被膜、伴结节性甲状腺肿、不伴甲状腺瘤均是颈中央区淋巴结转移的独立危险因素。结论PTC颈部淋巴结转移以中央区为主,其次为颈侧区,年龄<45岁、男性、多发灶、肿瘤直径>1.0 cm、侵及被膜均是颈部淋巴结转移的独立危险因素,临床应结合以上危险因素制定淋巴结清扫方案,以延长患者生存时间。

Objective To investigate the characteristics of cervical lymph node metastasis of thyroid papilloma carcinoma(PTC).Methods 96 PTC patients were selected.Statistics of cervical lymph node metastasis in PTC patients were counted,and clinical data were collected.The influencing factors of PTC cervical lymph node metastasis were analyzed based on whether central and cervical regional lymph metastasis existed.Results 28 cervical lymph node metastasis in PTC(29.17%),42(43.75%)(P<0.05);age<45 years,male,multiple focal,>1.0 cm,invasion and membrane were independent risk factors for cervical lymph node metastasis;age<45 years,male,multiple focal,tumor diameter,>1.0 cm,nodulous goiter and without thyroid tumor were independent risk factors for lymph node metastasis in the central neck.Conclusion PTC cervical lymph node metastasis is the central area,followed by the neck area,<45 years,male,multiple stoves,tumor diameter>1.0 cm,invasion and membrane are all independent risk factors of cervical lymph node metastasis.Risk factors should be considered to prolong the survival time of patients.