甲状腺乳头状癌临床特征及颈部淋巴结转移相关危险因素分析

Clinical features of papillary thyroid carcinoma and risk factors related to cervical lymph node metastasis

目的探讨甲状腺乳头状癌(PTC)临床特征及颈部淋巴结转移相关危险因素,为其外科治疗方式提供依据。方法选取桂林医学院附属医院2018年10月至2022年12月收治的经手术治疗的220例甲状腺乳头状癌患者为研究对象,分析其临床病理特征及颈部淋巴结转移相关危险因素。结果220例患者中,164例患者发生中央区和(或)侧颈区淋巴结转移(74.55%)。单因素分析结果显示,患者的性别、年龄、肿瘤直径、侵犯被膜、浸润性生长、多灶性、肿瘤位于甲状腺上部与颈部淋巴结转移相关(P<0.05);多因素logistic分析结果显示,男性、年龄(<45岁)、肿瘤直径(>1 cm)、肿瘤浸润性生长是PTC颈部淋巴结转移的独立危险因素(P<0.05)。结论对于男性、年龄<45岁,肿瘤直径>1 cm、肿瘤伴浸润性生长的PTC患者,颈部淋巴结转移风险较高,临床上应积极手术干预。

Objective To explore the clinical characteristics and risk factors related to cervical lymph node metastasis of papillary thyroid carcinoma(PTC),and provide a basis for its surgical treatment.Methods A total of 220 patients with papillary thyroid cancer treated by surgery in the Affiliated Hospital of Guilin Medical University from October 2018 to December 2022 were selected as the study objects,and their clinicopathological characteristics and risk factors related to cervical lymph node metastasis were analyzed.Results Among 220 patients,164(74.55%)had lymph node metastasis in the central and/or lateral cervical regions.Univariate analysis showed that gender,age,tumor diameter,invasion of the capsule,invasive growth,multifocal,tumor location in the upper thyroid gland,and cervical lymph node metastasis were correlated(P<0.05).The results of logistic multivariate analysis showed that male,age(<45 years old),tumor diameter(>1 cm),and invasive tumor growth were independent risk factors for cervical lymph node metastasis in PTC(P<0.05).Conclusion For male patients with PTC,who are less than 45 years old,have a tumor diameter greater than 1 cm,and have infiltrative growth,the risk of cervical lymph node metastasis is higher,and active surgical intervention should be taken in clinical practice.