甲状腺微小乳头状癌中央区淋巴结转移的危险因素分析

目的分析甲状腺微小乳头状癌(PTMC)的病理特征及中央区淋巴结转移的危险因素。方法回顾性分析178例PTMC患者的临床资料,总结病理特征,并应用Logistic多因素回归模型对中央区淋巴结转移的危险因素进行分析。结果本组PTMC患者的中央区淋巴结转移率为30.9%(55/178)。单因素分析显示,年龄<45岁、肿瘤最大直径>5 mm、合并包膜侵犯、癌灶多发、双侧癌灶与PTMC患者发生中央区淋巴结转移存在显著关联(P<0.05或P<0.01),性别、是否合并淋巴细胞性甲状腺炎与中央区淋巴结转移无显著关联(P>0.05);多因素分析显示,年龄<45岁、肿瘤最大直径>5 mm、癌灶多发、双侧癌灶、合并包膜侵犯均是PTMC患者发生中央区淋巴结转移的独立危险因素(P<0.01)。结论PTMC患者发生中央区淋巴结转移的危险因素有年龄<45岁、肿瘤最大直径>5 mm、癌灶多发、双侧癌灶、合并包膜侵犯,建议临床积极实施中央区淋巴结清扫术进行预防。

Analysis in risk factors of central lymph node metastasis in patients with minimal papillary thyroid carcinoma

Objective To analyze the risk factors of central lymph node metastasis in patients with papillary thyroid carcinoma(PTMC)and their pathological features.Methods The data of 178 patients with PTMC were analyzed retrospectively.The pathological characteristics of the patients were summerized.The risk factors of central lymph node metastasis were analyzed by Logistic regression model.Results The rate of central lymph node metastasis in 178 PTMC patients was 30.9%(55/178).Single factor analysis showed that central lymphatic metastasis was closely related to below 45 years of age,the largest tumor diameter more than 5 mm,combining with capsule invasion,multiple lesions,bilateral cancer lesions(P<0.05 or P<0.01),while had no correlations with gender and whether combining with lymphocytic thyroiditis or not(P>0.05).Multivariate analysis showed that below 45 years of age,maximum tumor diameter more than 5 mm,multiple cancer foci,bilateral cancer foci,and complicating envelop were independent risk factors for central lymph node metastasis in PTMC patients(P<0.01).Conclusion The risk factors of central lymph node metastasis include below 45 years of age,the largest tumor diameter more than 5 mm,multiple cancer foci,bilateral cancer foci,and complicating envelop.Therefore,it is recommended to actively perform lymph node dissection in central region for prevention.