| 是否合并桥本甲状腺炎的甲状腺乳头状癌患者的临床病理特征及与淋巴结转移相关性的分析 |
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| 引用本文： | 殷秀玲,樊 菁,延常姣,郭丝锦.是否合并桥本甲状腺炎的甲状腺乳头状癌患者的临床病理特征及与淋巴结转移相关性的分析[J].现代肿瘤医学,2023,0(2):252-257. |
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| 作者姓名： | 殷秀玲 樊 菁 延常姣 郭丝锦 |
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| 作者单位： | 空军军医大学西京医院甲乳血管外科，陕西 西安 710032 |
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| 基金项目： | 陕西省社会发展科技攻关项目（编号:2016SF-298） |
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| 摘 要： | 目的:探讨甲状腺乳头状癌合并桥本甲状腺炎患者临床病理特征以及合并桥本甲状腺炎对淋巴结转移的影响。方法:回顾性分析我院2014年10月至2019年10月术后病理证实为甲状腺乳头状癌3 411例患者临床资料，其中合并桥本患者498例，未合并桥本患者2 913例，经过倾向性评分匹配方法对两组患者进行匹配，得到组间协变量均衡样本，比较两组患者临床病例特征并分析患者淋巴结转移的危险因素。结果:经过倾向性评分匹配后，甲状腺乳头状癌患者是否合并桥本甲状腺炎仅与病灶大小和BRAF V600E基因突变显著相关（P＜0.05），而与病灶数目、侵犯包膜、淋巴结转移、中央区淋巴结转移、颈侧区淋巴结转移以及淋巴结转移数目无关（P＞0.05）。Logistic回归分析显示年龄≥55岁PTC患者淋巴结转移的发生风险是年龄<55岁患者的0.957倍（OR=0.957，P＜0.001）。肿瘤病灶＞1 cm患者淋巴结转移的发生风险是病灶≤1 cm患者的2.697倍（OR=2.697，P＜0.001）。肿瘤病灶多灶的患者淋巴结转移的发生风险是单灶患者的2.186倍（OR=2.186，P＜0.001）。结论:合并桥本甲状腺炎与更小的肿瘤病灶和更高的BRAF V600E基因突变率显著相关，而与淋巴结转移无关。患者年龄≥55岁是甲状腺乳头状癌患者淋巴结转移的独立保护因素，而病灶>1 cm和病灶多灶是淋巴结转移的独立危险因素。
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| 关 键 词： | 甲状腺乳头状癌 桥本甲状腺炎 淋巴结转移 危险因素 |
The clinicopathologic features of papillary thyroid carcinoma patients with or without Hashimoto' s thyroiditis and its correlation with lymph node metastasis |
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| YIN Xiuling,FAN Jing,YAN Changjiao,GUO Sijin.The clinicopathologic features of papillary thyroid carcinoma patients with or without Hashimoto' s thyroiditis and its correlation with lymph node metastasis[J].Journal of Modern Oncology,2023,0(2):252-257. |
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| Authors: | YIN Xiuling FAN Jing YAN Changjiao GUO Sijin |
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| Affiliation: | Department of Thyroid,Breast and Vascular Surgery,Xijing Hospital,Air Force Medical University,Shaanxi Xi'an 710032,China. |
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| Abstract: | Objective:To investigate the clinicopathologic features of papillary thyroid carcinoma with Hashimoto's thyroiditis and the effect of Hashimoto's thyroiditis on lymph node metastasis.Methods:The clinical data of 3 411 patients with pathologically confirmed papillary thyroid carcinoma from October 2014 to October 2019 in Xijing Hospital were retrospectively analyzed,including 498 patients with Hashimoto's disease and 2 913 patients without Hashimoto's disease.The two groups were matched by propensity score matching method to obtain a balanced sample of group covariates.The clinical case characteristics of the two groups were compared and the risk factors of lymph node metastasis were analyzed.Results:After propensity score matching,papillary thyroid carcinoma patients with Hashimoto's thyroiditis were significantly correlated with lesion size and BRAF V600E gene mutation only (P＜0.05),but not with the number of lesions,invasion capsule,lymph node metastasis,central lymph node metastasis,cervical lymph node metastasis and the number of lymph node metastasis (P＞0.05).Logistic regression analysis showed that PTC patients age≥55 years had a 0.957-fold higher risk of lymph node metastasis than patients age<55 years (OR=0.957,P＜0.001).The risk of lymph node metastasis was 2.697-fold higher in patients with tumor lesions>1 cm than in those with lesions≤1 cm (OR=2.697,P＜0.001).Patients with multifocal tumor lesions had a 2.186-fold higher risk of lymph node metastasis than those with unifocal lesions (OR=2.186,P＜0.001).Conclusion:Combined Hashimoto's thyroiditis is significantly associated with smaller tumor lesions and a higher rate of BRAF V600E gene mutation,but not with lymph node metastasis.Patient age≥55 years was an independent protective factor for lymph node metastasis in patients with papillary thyroid carcinoma,while lesions>1 cm and multifocal lesions were independent risk factors for lymph node metastasis. |
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| Keywords: | papillary thyroid carcinoma Hashimoto's thyroiditis lymph node metastasis risk factors |
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