cN0甲状腺微小乳头状癌中央区淋巴结转移危险因素分析

Analysis of risk factors for lymph node metastasis in the central region of cN0 thyroid micropapillary carcinoma

目的调查cN0甲状腺微小乳头状癌中央区淋巴结转移危险因素。方法回顾性分析2020年5月至2021年11月江门市新会区人民医院cN0甲状腺微小乳头状癌患者106例的临床资料,依据中央区淋巴结转移情况分为转移组(49例)、未转移组(57例)两组。分析患者中央区淋巴结转移的危险因素。结果106例患者中,中央区淋巴结转移49例,未转移57例,转移率为46.23%。转移组男性、肿瘤位置为下、存在微小钙化、存在侵犯被膜所占比例高于未转移组(P<0.05),年龄<55岁、肿瘤直径<5mm所占比例低于未转移组(P<0.05),但两组患者合并结节性甲状腺肿、桥本甲状腺炎所占比例无显著差异(P>0.05)。多因素Logistic回归分析显示,106例患者中央区淋巴结转移危险因素包括男性、微小钙化、侵犯被膜(P<0.05)。结论cN0甲状腺微小乳头状癌中央区淋巴结转移危险因素包括男性、微小钙化、侵犯被膜,建议预防性与治疗性清扫中央区淋巴结。

Objective To investigate the risk factors of lymph node metastasis in the central region of cN0 thyroid micropapillary carcinoma.Method The clinical data of 106 patients with cN0 thyroid micropapillary carcinoma in Jiangmen Xinhui District People's Hospital from May 2020 to November 2021 were retrospectively analyzed.According to the lymph node metastasis in the central region,they were divided into two groups:metastatic group(49 cases)and non-metastatic group(57 cases).The risk factors of lymph node metastasis in the central region of patients were analyzed.Result Of the 106 patients,49 had lymph node metastasis in the central region and 57 had no metastasis.The proportion of males,tumor location,microcalcification and invasion of capsule in the metastatic group was higher than that in the non-metastatic group(P<0.05),the proportion of patients with age<55 years old and tumor diameter<5 mm was lower than those without metastasis(P<0.05),however,there was no significant difference in the proportion of patients with nodular goiter and Hashimoto's thyroiditis between the two groups(P>0.05).Multivariate logistic regression analysis showed that the risk factors of lymph node metastasis in the central region of 106 patients included male,microcalcification and capsule invasion(P<0.05).Conclusion The risk factors of lymph node metastasis in the central region of cN0 thyroid micropapillary carcinoma include male,microcalcification,and invasion of capsule.Preventive and therapeutic dissection of lymph nodes in the central region is recommended.