单侧多灶性甲状腺微小乳头状癌颈部淋巴结转移预测因素的临床分析

Clinical analysis of predictors of cervical lymph node metastases in unilateral multifocal papillary thyroid microcarcinoma

目的 探讨单侧多灶性甲状腺微小乳头状癌颈部淋巴结转移的预测因素。方法 回顾性分析2010年1月至2020年1月哈尔滨医科大学附属二院收治的458例单侧多灶性甲状腺微小乳头状癌的临床数据。通过单因素和多因素logistic回归分析颈部中央区和颈侧区淋巴结转移的危险因素。结果 单因素分析表明,颈部中央区淋巴结转移情况在肿瘤直径和、腺体外侵袭和桥本氏甲状腺炎方面比较,差异均具有统计学意义(均P<0.05)。颈侧区淋巴结转移情况在肿瘤最大直径、肿瘤直径和以及中央区淋巴结转移方面比较,差异均具有统计学意义(均P<0.01)。多因素分析表明,桥本氏甲状腺炎是中央区淋巴结转移的独立危险因素(P<0.01);肿瘤直径和以及中央区淋巴结转移是颈侧区淋巴结转移的独立危险因素(均P<0.01)。结论单侧多灶性甲状腺微小乳头状癌中,桥本氏甲状腺炎是中央区淋巴结转移的独立危险因素,肿瘤直径和以及中央区淋巴结转移是颈侧区淋巴结转移的独立危险因素。

Objective To investigate the predictors of cervical lymph node metastases(LNM)in unilateral multifocal papillary thyroid microcarcinoma(PTMC).Methods The clinical data of 458 cases of unilateral multifocal PTMC from January 2010 to January 2020 from the Second Affiliated Hospital of Harbin Medical University were retrospectively analyzed.The risk factors for LNM in the central and lat-eral regions were analyzed by univariate and multivariate logistic regression analysis.Results Univariate analysis showed that total tumor diameter,extraglandular invasion,and Hashimoto's thyroiditis were closely related to central LNM(all P<0.05).Maximum tumor diameter,total tumor diameter,and central LNM were related to lateral LNM(all P<0.01).Multivariate analysis indicated that Hashimoto's thyroid-itis was an independent risk factor for central LNM(P<0.01),while total tumor diameter and central LNM were independent risk factors for lateral LNM(both P<0.01).Conclusions In unilateral multifocal PTMC,Hashimoto's thyroiditis is an independent risk factor for central LNM,while total tumor diameter and central LNM are independent risk factors for lateral LNM.