摘要
目的分析颈淋巴结阴性(cN0期)甲状腺乳头状癌右侧喉返神经后方淋巴结(Ⅵ-B)转移的危险因素及其临床意义。方法回顾性分析2017年6月至2020年6月在廉江市人民医院接受手术治疗的86例cN0期甲状腺乳头状癌患者的临床资料,观察患者的右侧Ⅵ-B转移情况,根据有无右侧Ⅵ-B转移分为转移组(16例)和未转移组(70例),收集两组的临床资料,采用多因素logistic回归分析cN0期甲状腺乳头状癌右侧Ⅵ-B转移危险因素。结果86例患者中,有16例发生右侧Ⅵ-B转移,发生率为18.60%。经单因素分析显示,年龄、肿瘤大小、肿瘤包膜侵犯、肿瘤数目、右侧Ⅵ-A区淋巴结转移是cN0期甲状腺乳头状癌患者发生右侧Ⅵ-B转移的可能危险因素(P<0.05);经多因素logistic回归分析显示,原发肿瘤直径>1 cm、包膜侵犯、肿瘤多发、右侧Ⅵ-A区淋巴结转移阳性是cN0期甲状腺乳头状癌右侧Ⅵ-B转移的独立危险因素(P<0.05)。结论在cN0期甲状腺乳头状癌患者中,原发肿瘤直径>1 cm、包膜侵犯、肿瘤多发、右侧Ⅵ-A区淋巴结转移阳性是引起右侧Ⅵ-B转移的危险因素,在cN0期甲状腺乳头状癌行右侧中央区淋巴结清扫时,右侧Ⅵ-B淋巴结应常规清扫,尤其当原发肿瘤直径>1 cm、包膜侵犯、肿瘤多发、右侧Ⅵ-A区淋巴结转移阳性时,更应注重右侧Ⅵ-B淋巴结清扫的彻底性。
Objective To analyze the risk factors for lymph node posterior to the right recurrent laryngeal nerve(Ⅵ-B)metastasis in cervical lymph node negative(cN0 stage)papillary thyroid carcinoma and the clinical significance.Methods The clinical data of 86 patients with cN0 stage papillary thyroid carcinoma who underwent surgery in Lianjiang People's Hospital from June 2017 to June 2020 were retrospectively analyzed and the rightⅥ-B metastasis conditions of patients were observed.The patients were divided into metastasis group(16 cases)and non-metastasis group(70 cases)according to the presence of rightⅥ-B metastasis,and the clinical data of both groups of patients were collected.The risk factors for rightⅥ-B metastasis in cN0 stage papillary thyroid carcinoma were analyzed by multifactorial logistic regression.Results Among 86 patients,16 patients had rightⅥ-B metastasis,with an incidence rate of 18.60%.Univariate analysis showed that age,tumor size,tumor capsular invasion,tumor number,and lymph node metastasis in the rightⅥ-A area were the possible risk factors for rightⅥ-B metastasis in patients with cN0 stage papillary thyroid carcinoma(P<0.05).Meanwhile,multifactorial logistic regression analysis showed that primary tumor diameter>1 cm,capsular invasion,multiple tumors,and positive lymph node metastasis in the rightⅥ-A area were the independent risk factors for rightⅥ-B metastasis occurred in patients with cN0 stage papillary thyroid carcinoma(P<0.05).Conclusion In patients with cN0 stage papillary thyroid carcinoma,primary tumor diameter>1 cm,capsular invasion,multiple tumors,and positive lymph node metastasis in the rightⅥ-A area are risk factors for rightⅥ-B metastasis.The rightⅥ-B lymph node should be routinely dissected when lymph node dissection in the right central area is performed for cN0 stage papillary thyroid carcinoma.Especially when such factors exist as the primary tumor diameter>1 cm,capsular invasion,multiple tumors,and positive lymph node metastasis in the rightⅥ-A area,the thoroughness of rightⅥ-B lymph node dissection should be paid more attention.
作者
林木本
林国文
王观胜
黄少平
LIN Muben;LIN Guowen;WANG Guansheng;HUANG Shaoping(Lianjiang People's Hospital,Guangdong,Lianjiang 524400,China)
出处
《中国医药科学》
2021年第20期174-177,共4页
China Medicine And Pharmacy
关键词
颈淋巴结阴性
甲状腺乳头状癌
右侧喉神经后方淋巴结转移
危险因素
Negative cervical lymph node
Papillary thyroid carcinoma
Lymph node posterior to the right recurrent laryngeal nerve metastasis
Risk factors
