摘要
目的探讨甲状腺乳头状癌颈部淋巴结转移的危险因素。方法回顾性分析2014年6月至2018年6月于郑州大学第一附属医院甲状腺外科行手术治疗并经术后病理证实的2014例PTC患者的临床资料,采用t检验、χ^2检验、连续校正χ^2检验或Fisher确切概率检验比较两组患者临床病理特征,采用多因素Logistic回归分析侧区淋巴结转移的危险因素。结果多因素Logistic回归分析侧区淋巴结转移危险因素显示,双叶癌灶,浸润性生长,肿瘤直径>2cm和中央区淋巴结转移是侧区淋巴结转移的危险因素,BRAFV600E突变阳性是侧区淋巴结转移的保护因素。结论BRAFV600E突变阴性,双侧腺叶发生,癌灶浸润性生长,直径>2cm和中央区淋巴结转移的患者出现颈部侧区淋巴结转移的可能性更大,此时若术前彩超提示可疑的侧区淋巴结肿大或转移,建议采取更积极的手术策略,进行侧区淋巴结清扫。
Objective To investigate the risk factors of lateral cervical region lymph nodes metastasis in papillary thyroid cancer. Methods The clinical data of 2014 patients undergoing surgical treatment in Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University from June 2014 to June 2018, who had pathologically confirmed PTC were retrospectively analyzed. The t -test,χ^2 test or Fisher’s exact probabilities were used to compare clinicopathologic characteristics between the two groups. Results Multivariate analysis of lateral cervical region lymph nodes metastasis showed that the diameter of cancer overlarge than 2 centimeter, tumor happening in bilateral lobular of thyroid, invasive growth of cancer and central lymph nodes metastasis were the risk factors, while the BRAF V600E mutation was protective factors. Conclusion Once there exist characteristics including BRAF V600E wild-type, diameter of cancer overlarge than 2 centimeter, tumor happening in bilateral lobular of thyroid, invasive growth of cancer and central lymph nodes metastasis, the possibility of cervical lateral lymph node metastasis is higher. If it doubts about central lymph node metastasis, it is better to perform lateral lymph node dissection.
作者
邱贝
赵波
董烨尧
张乐乐
殷德涛
QIU Bei;ZHAO Bo;DONG Ye-yao;ZHANG Le-le;YIN De-tao(Department of Thyroid Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China)
出处
《河南医学研究》
CAS
2019年第10期1749-1752,共4页
Henan Medical Research
基金
中原科技创新领军人才资助项目(194200510011)
河南省高校科技创新团队支持计划(19IRTSTHN002)
作者简介
通信作者:殷德涛,E-mail:detaoyin@zzu.edu.cn.
