甲状腺微小癌淋巴结转移影响因素分析

目的探讨甲状腺微小癌淋巴结转移的影响因素及临床应用价值。方法回顾性收集2003年1月～2008年12月在我院行手术治疗的96例甲状腺微小癌患者,根据是否发生淋巴结转移分为转移组28例和未转移组68例,通过单因素及多因素Logistic回归分析进行研究。结果本研究的TMC发生淋巴结转移率为29.2%(28/96);通过诊断试验ROC分析发现肿瘤直径0.6cm为其最佳临界值,肿瘤直径(OR=3.717)和甲状腺被膜侵犯(OR=3.459)因素对淋巴结转移的影响均有统计学意义。结论 TMC患者具有一定比例的颈部淋巴结转移率,尤其是肿瘤最大直径≥0.6cm以及甲状腺被膜受侵犯患者,行择区性淋巴结清扫术是有效的治疗方法。

Lymph Node Metastasis in Thyroid Microcarcinoma:Analysis of Influencing Factors

Objective To analyze the clinical factors influencing on lymph node metastasis in thyroid micmcarcinoma（TMC）. Methods The retrospective collection of 96 cases of TMC receiving operations from Jan 2003 to Dec 2008 was carried out. According to whether metastasis happened,96 cases were divided into two groups,metastasis group （28cases in it）and nonmetastasis group （68cases in it）,and single factor and muhifactorial Logistic Regression analysis was used. Results The lymph node metastasis rate of TMC patients was 29.2%（28/96）. We defined the optimal critical value（0.6cm）of tumor diameter by using diagnostic test ROC analysis, tumor diameter（OR=3.717）and thyroid capsule invasion （OR=3.459）, with impact on lymph node metastasis. Conclusion The TMC patients have a certain tendency to metastasize, especially in the maximal tumor diameter≥ 0.6cm and the thyroid capsule invasion, and the selective lymph node dissection is an effective treatment.