甲状腺微小乳头状癌临床病理特征与中央区淋巴结转移的相关性探讨

目的:探讨甲状腺微小乳头状癌（PTMC）患者临床病理特征与中央区淋巴结转移的关系。方法:回顾性分析413例PTMC患者的临床病理特征，应用χ2 检验和多因素Logistic回归模型分析中央区淋巴结转移的危险因素。结果:413例PTMC患者中央区淋巴结转移率为57.9%（239例）。单因素分析显示，男性、年龄＜45岁、肿瘤直径＞5 mm、肿瘤位于甲状腺下极、多灶性、包膜侵犯等均与中央区淋巴结转移有关（P＜0.05）。多因素分析显示，年龄＜45岁、包膜侵犯是PTMC中央区淋巴结转移的独立危险因素（P＜0.01）。结论:具备年龄＜45岁、包膜侵犯等特征的PTMC患者，较易发生中央区淋巴结转移，建议行预防性中央区淋巴结清扫。

Correlation between clinicopathological features of papillary thyroid microcarcinoma and central compartment nodal metastasis

Objective: To explore the correlation between the clinical features of papillary thyroid microcarcinoma (PTMC) and central compartment lymph node (CCLN) metastasis in PTMC. Methods: Data of 413 patients with PTMC were retrospectively analyzed. Chi-square test and multivariate logistic regression analysis were used to study the risk factors. Results:CCLN metastasis were found in 239 of 413 patients(57.9%). The univariate analysis showed that male gender, age under 45 years,tumor size bigger than 5 mm，tumor location in the lower third of the thyroid，multifocal，capsular invasion were significantly associated with CCLN metastasis（P＜0.05）. The multivariate analysis showed that the age below 45 years and capsular invasion were independently correlated with CCLN metastasis（P＜0.01）.Conclusion:A prophylactic neck dissection of the central compartment should be considered particularly in PTMC patients with age below 45 years and capsular invasion.