摘要
目的探讨分析甲状腺微小乳头状癌(PTMC)合并桥本甲状腺炎(HT)患者中央区淋巴结转移的危险因素。方法回顾性分析郑州大学第一附属医院甲状腺外科2018年1月-12月收治的572例PTMC患者的病理特征。筛选其中合并HT的患者共140例,分析性别、年龄、肿瘤大小、病灶数、BRAFV600E基因及腺体外侵犯等临床特征是否与中央区淋巴结转移相关。采用SPSS 23.0软件进行统计分析。结果对140例PTMC合并HT患者进行单因素分析,其中,肿瘤大小≥6 mm(χ2=5.376,P=0.020)、多灶性(χ2=7.986,P=0.005)、BRAFV600E基因突变阳性(χ2=5.072,P=0.024)及腺体外侵犯(χ2=7.778,P=0.005),差异有统计学意义。多因素logistic回归分析发现,多灶性(OR=2.473,P=0.018),腺体外侵犯(OR=3.608,P=0.048)是PTMC合并HT患者中央区淋巴结转移的独立危险因素。结论在PTMC合并HT情况下,当患者术前有证据显示存在多灶性或者腺体外侵犯时,中央区淋巴结转移风险增高,此时推荐预防性中央区淋巴结清扫。
Objective To investigate the risk factors of central lymph node metastasis for thyroid microcarcinoma(PTMC)combined with Hashimoto thyroiditis(HT).Methods A total of 572 patients with PTMC were admitted to the Thyroid Surgery Department of the First Affiliated Hospital of Zhengzhou University from January to December 2018.Their all pathological features were retrospectively analyzed.A total of 140 PTMC patients combined with HT were screened.The software of SPSS 23.0 was used to analyze risk factors related to lymph node metastasis in central region,which included gender,age,tumor size,number of lesions,mutated BRAFV600E gene,external invasion.Results Single factor analysis of these 140 patients showed,tumor size 6 mm or higher(χ2=5.376,P=0.020),multifocal(χ2=7.986,P=0.005),BRAFV600E mutation positive(χ2=5.072,P=0.024)and external invasion(χ2=7.778,P=0.005)were statistically significant(P<0.05).Multivariate logistic regression analysis showned,multifocal(OR=2.473,P=0.018)and external invasion(OR=3.608,P=0.048)were independent risk factors for lymph node metastasis in central region of patients who had PTMC combined with HT.Conclusion In patients who have PTMC combined with HT,the risk of central lymph node metastasis increased when patients had multifocal or external invasion before surgery,at this time,preventive central lymph node dissection was recommended.
作者
赵文鼎
杜军威
刘森源
邱新光
Zhao Wending;Du Junwei;Liu Senyuan;Qiu Xinguang(Department of Thyroid Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《国际外科学杂志》
2020年第11期743-747,共5页
International Journal of Surgery
基金
河南省高等学校重点科研项目(14A320077)。
关键词
淋巴转移
危险因素
回顾性研究
甲状腺微小乳头状癌
桥本甲状腺炎
Lymphatic metastasis
Risk factors
Retrospective studies
Hashimoto thyroiditis
Papillary thyroid micro carcinoma
作者简介
通信作者:邱新光,Email:qxg2000@126.com。
