摘要
目的:探究甲状腺乳头状癌(PTC)患者颈侧区淋巴结转移的临床特征,并对其相关危险因素进行分析。方法:回顾性选取2019年2月至2022年2月期间我院收治的可疑颈侧区淋巴结转移的PTC患者114例,统计颈侧区淋巴结数量分布情况、转移分布情况和跳跃性转移累及颈侧区情况,分析PTC患者临床特征与其颈侧区淋巴结转移的关系。结果:114例可疑颈侧区淋巴结转移患者中最终确诊为颈侧区淋巴结转移者95例,其中11例患者为跳跃性转移。95例颈侧区淋巴结阳性患者中共检出1983个淋巴结,Ⅲ区淋巴结分布最多,占73.68%,其次是IV区,占64.21%,再次为Ⅱ区,占54.74%,Ⅴ区淋巴结分布最多少,仅为12.63%。95例PTC患者中单区累及32例,占33.68%,双区累及41例,占43.16%,三区累及13例,占13.69%,四区累及9例,占9.47%。PTC病灶位于上极时,单区受累3例,双区受累1例,三区受累0例;PTC病灶位于中极时,单区受累2例,双区受累2例,三区受累3例。单因素分析结果显示,PTC颈侧区淋巴结在多发病灶、双侧、侵及被膜、肿瘤直径越大和中央区淋巴结阳性的患者中转移率更高(P<0.05)。多因素分析结果显示,PTC患者颈侧区淋巴结转移的危险因素为中央区淋巴结转移阳性(P<0.05)。结论:颈侧区淋巴结转移分区由高到底依次为Ⅲ区、Ⅳ区、Ⅱ区和Ⅴ区,以多区受累为主,跳跃性转移率较低,中央区淋巴结转移阳性是颈侧区淋巴结转移的独立危险因素。
Objective:To explore the clinical characteristics of cervical lateral lymph node metastasis in patients with papillary thyroid carcinoma(PTC),and to perform the analysis on its related risk factors.Methods:The clinical data of 114 PTC patients with suspected lateral cervical lymph node metastasis who were admitted to the hospital between February 2019 and February 2022 were retrospectively selected.The lateral cervical lymph node quantity distribution,metastasis distribution and skip metastasis involving lateral cervical region were statistically analyzed,and the relationship between the clinical characteristics of patients with PTC and the lymph node metastasis in lateral cervical region was analyzed.Results:Among the 114 patients,there were 95 cases of cervical lateral lymph node metastasis and 11 cases of skip metastasis.1,983 lymph nodes were detected among 95 patients with positive lateral cervical lymph nodes.The lymph node distribution in regionⅢwas the highest(73.68%),followed by regionⅣ(64.21%)and regionⅡ(54.74%)and the lowest in regionⅤ(12.63%).Among the 95 patients with PTC,there were 32 cases(33.68%)of single-region involvement,41 cases(43.16%)of double-region involvement,13 cases(13.69%)of three-region involvement and 9 cases(9.47%)of four-region involvement.When PTC lesions were situated in the upper pole,there were 3 cases of single-region involvement,1 case of double-region involvement and 0 cases of three-region involvement.When PTC lesions were located in the middle pole,there were 2 cases of single-region involvement,2 cases of double-region involvement and 3 cases of three-region involvement.Univariate analysis showed that the patients with multiple lesions,bilateral lesions,invasive capsule,large tumor diameter and positive central lymph node had higher PTC cervical lateral lymph node metastasis rate(P<0.05).Multivariate analysis revealed that the risk factor for cervical lateral lymph node metastasis was positive central lymph node metastasis(P<0.05).Conclusion:The region of cervical lateral lymph node metastasis is in descending order of regionⅢ,regionⅣ,regionⅡand regionⅤ.Cervical lateral lymph node metastasis is mainly with multi-regional involvement and with low skip metastasis.Positive central lymph node metastasis is an independent risk factor for cervical lateral lymph node metastasis.
作者
杜镇鸿
邱红艳
DU Zhenhong(The Affilliated Chengdu 363 Hospital of Southwest Medical University,Sichuan Chengdu 610000,China)
出处
《河北医学》
CAS
2022年第12期2038-2043,共6页
Hebei Medicine
基金
四川省医学(青年创新)科研课题,(编号:S20068)。
关键词
甲状腺乳头状癌
淋巴结转移
中央区淋巴结转移
颈侧区淋巴结转移
危险因素
Papillary thyroid carcinoma
Lymph node metastasis
Central lymph node metastasis
Cervical lateral lymph node metastasis
Risk factors
