CN_(0)期甲状腺微小乳头状癌患者发生非小容量中央区淋巴结转移的影响因素

Influencing factors of non-small volume central lymph node metastasis in patients with CN_(0) thyroid micropapillary carcinoma

目的:分析术前临床淋巴结阴性(CN_(0))甲状腺微小乳头状癌(PTMC)患者发生非小容量中央区淋巴结转移(NSVCLNM)的影响因素。方法:回顾性分析2018年1月至2021年2月该院收治的538例CN_(0)期PTMC患者的临床资料。统计CN_(0)期PTMC患者发生NSVCLNM情况,并采用Logistic回归分析CN_(0)期PTMC患者发生NSVCLNM的影响因素。结果:538例CN_(0)期PTMC患者中,发生NSVCLNM 30例,占5.60%;未发生NSVCLNM 508例,占94.40%。单因素分析结果显示,不同本甲状腺炎情况、BRAFV600E基因情况、BMI、多灶性情况、被膜侵犯情况、AJCC分期患者NSVCLNM发生率比较,差异均无统计学意义(P>0.05);男性、年龄<40岁、双侧癌灶、脉管侵犯、颈侧区淋巴结转移患者的NSVCLNM发生率更高,与其他类别比较,差异均有统计学意义(P<0.05);Logistic回归分析结果显示,男性、年龄<40岁、双侧癌灶、颈侧区淋巴结转移均为影响CN_(0)期PTMC患者发生NSVCLNM的危险因素(OR>1,P<0.05)。结论:男性、年龄<40岁、双侧癌灶、颈侧区淋巴结转移均为影响CN_(0)期PTMC患者发生NSVCLNM的危险因素。

Objective:To analyze influencing factors of non-small volume central lymph node metastasis(NSVCLNM)in patients with preoperative clinical lymph node negative(CN_(0))thyroid micropapillary carcinoma(PTMC).Methods:The clinical data of 538 patients with CN_(0) PTMC admitted to the hospital from January 2018 to February 2021 were retrospectively analyzed.The incidence of NSVCLNM in the patients with CN_(0) PTMC was statistically analyzed.Logistic regression analysis was used to analyze the influencing factors of NSVCLNM in the patients with CN_(0) PTMC.Results:Of the 538 patients with CN_(0) PTMC,30 had NSVCLNM,accounting for 5.60%,and were set as occurrence group;508 cases had no NSVCLNM,accounting for 94.40%,and were set as non-occurrence group.Univariate analysis showed that there were no significant difference in the incidence of NSVCLNM in patients with different thyroid inflammation,BRAFV600E gene,BMI,multifocality,capsule invasion and AJCC stage(P>0.05).The incidence of NSVCLNM were higher in patients with male,age<40 years,bilateral cancer,vascular invasion,and lateral cervical lymph node metastasis,and the difference were statistically significant compared with other categories(P<0.05).Logistic regression analysis showed that male,age<40 years old,bilateral tumor,and lateral cervical lymph node metastasis were all risk factors for NSVCLNM in the PTMC patients(OR>1,P<0.05).Conclusions:Male,age<40 years old,bilateral tumor,and lateral cervical lymph node metastasis are the risk factors for NSVCLNM in the PTMC patients.