甲状腺乳头状癌侧颈区淋巴结转移的相关独立危险因素

目的探讨甲状腺乳头状癌（PTC）发生中央区与侧颈区淋巴结转移的独立危险因素。方法回顾性分析247例接受淋巴结根治术的PTC患者，按转移区域将患者分为未转移组（NLNM，n=152）、单纯中央区转移组（CLNM组，n=47）、侧颈区转移组（LLNM组，n=48），单因素分析颈部淋巴结转移的危险因素，多因素分析中央区和侧颈区淋巴结转移的独立危险因素。结果单因素分析显示年龄、病灶最大径、纵横比、包膜接触对预测颈部淋巴结转移有统计学意义（χ2=27.842、32.554、8.716、30.770，P < 0.05）。多因素分析显示年龄和病灶最大径是预测CLNM及LLNM的独立预测因素（P < 0.05，OR=0.203、2.657）；包膜接触范围仅是LLNM的独立预测因素（P < 0.001，OR=2.090）。年龄与CLNM和LLNM均呈负相关（β=-1.596、-1.285）。结论年龄 < 45岁、病灶最大径 > 10 mm、包膜接触对颈部淋巴结转移具有重要预测价值。病灶包膜接触范围对于LLNM有显著的预测价值，包膜接触范围越大，发生转移可能越大。 

Risk factors of cervical lymph node metastasis in papillary thyroid carcinoma

ObjectiveTo explore the risk factors of central and lateral cervical lymph node metastasis in papillary thyroid carcinoma (PTC).MethodsA total of 247 patients with PTC were retrospectively analyzed. According to the metastatic region, the patients were divided into three groups: non metastatic group (NLNM, n=152), simple central region metastasis group (CLNM, n=47) and lateral cervical region metastasis group (LLNM, n=48). Univariate analysis was used to analyze the risk factors of cervical lymph node metastasis, and multivariate analysis was used to analyze the independent risk factors of central and lateral cervical lymph node metastasis.ResultsUnivariate analysis showed that age, maximum diameter of lesion, aspect ratio and capsular contact were significantly in predicting cervical lymph node metastasis (P < 0.05). Multivariate analysis showed that age and the maximum diameter of lesion were independent predictors of clnm and llnm (P < 0.05). The capsule contact area was only independent predictor of llnm (P < 0.001, OR=2.090). Age was negatively correlated with clnm and llnm (β=-1.596, -1.285).ConclusionAge < 45 years old, maximum diameter of lesion > 10 mm and capsule contact are important predictors of cervical lymph node metastasis. The larger the contact area, the greater the possibility of metastasis.