甲状腺乳头状癌CN0期患者淋巴结转移危险因素分析

Analysis of risk factors for lymph node metastasis in patients with CN0 papillary thyroid carcinoma

目的:探讨CN0期甲状腺乳头状癌(PTC)患者淋巴结转移及多枚淋巴结转移的危险因素。方法:回顾性分析2013年1月-2022年12月空军军医大学西京医院行淋巴结清扫的3099例CN0期PTC患者临床资料,单因素及多因素logistic回归分析淋巴结转移及多枚淋巴结转移的危险因素。结果:男性、年龄<55岁、多灶病灶、病灶大小>2 cm是CN0期PTC患者淋巴结转移的独立危险因素(P<0.05),而合并糖尿病是淋巴结转移的独立保护因素(P<0.05)。年龄<55岁、包膜侵犯、多灶病灶是淋巴结数目≥3枚的独立危险因素(P<0.05)。结论:当CN0期PTC患者为男性、年龄<55岁、多灶病灶、病灶大小>2 cm时,要高度警惕淋巴结转移的可能性。

Objective To explore the risk factors of lymph node metastasis and multiple lymph node metastasis in patients with stage CN0 papillary thyroid carcinoma.Methods The clinical case data of 3099 patients with CN0 papillary thyroid cancer who underwent lymph node dissection at Xijing Hospital of Air Force Medical University from January 2013 to December 2022 were retrospectively analyzed,univariate and multivariate logistic regression were used to analyze the risk factors of lymph node metastasis and multiple lymph node metastasis.Results Male gender,age<55 years,multifocal lesions,and lesion size≥2 cm were independent risk factors for lymph node metastasis in CN0 patients(P<0.05),while diabetes was an independent protective factor for lymph node metastasis(P<0.05).Age<55 years,capsular invasion,and multifocal lesions were independent risk factors for the presence of≥3 lymph nodes with metastasis(P<0.05).Conclusion In CN0 stage PTC patients,special attention should be given to the possibility of lymph node metastasis when they are male,aged<55 years,have multifocal lesions,or have lesion size>2 cm.