甲状腺乳头状癌颈部淋巴结转移特点及相关危险因素分析

目的 探讨甲状腺乳头状癌（PTC）临床病理特征及影响颈部淋巴结转移的危险因素。方法 回顾性分析我院2015年1月~2017年12月收治的515例PTC的临床资料，分析颈部淋巴结转移特点及相关危险因素。结果 PTC颈部淋巴结转移率为44.27%，中央组（Ⅵ区）淋巴结转移率高于侧区（P＜0.05）。单因素分析结果示性别、年龄、多灶、癌灶最大径、侵犯被膜和颈部淋巴结转移有关（P＜0.05）。多因素分析结果示男性、年龄＜55岁、多灶病变、癌灶最大径＞10 mm、被膜受侵犯是发生颈部淋巴结转移的独立危险因素（P＜0.05）。结论 Ⅵ区转移率最高，行颈淋巴结清扫时应将Ⅵ区作为常规清扫区域。对于男性、年轻、多灶病变、癌灶最大径＞10 mm、被膜受侵犯的患者应高度警惕颈部淋巴结转移的可能。

Analysis of Cervical Lymph Node Metastasis and Related Risk Factors in Papillary Thyroid Carcinoma

Objective To investigate the clinicopathological features of papillary thyroid carcinoma (PTC) and the risk factors affecting cervical lymph node metastasis. Methods The clinical data of 515 patients with PTC admitted to our hospital from January 2015 to December 2017 were retrospectively analyzed. The characteristics of cervical lymph node metastasis and related risk factors were analyzed. Results The lymph node metastasis rate of PTC was 44.27%. The lymph node metastasis rate of the central group (VI area) was higher than that of the lateral area (P<0.05). Univariate analysis showed gender, age, multifocal, maximum tumor diameter, invasion of the capsule and cervical lymph node metastasis (P<0.05). Multivariate analysis showed that males, age <55 years, multifocal lesions, maximum tumor diameter >10 mm, and capsule involvement were independent risk factors for cervical lymph node metastasis (P<0.05). Conclusion The metastasis rate of the VI area is the highest. The VI area should be used as the routine cleaning area when the neck lymph node is cleaned. For male, young, multifocal lesions, patients with a maximum diameter of >10 mm, and the capsule is invaded, patients should be highly alert to the possibility of cervical lymph node metastasis.