甲状腺微小乳头状癌中央区淋巴结转移及临床因素分析

目的 分析甲状腺微小乳头状痛的临床因素与中央区淋巴结转移之间的关系.方法 回顾性分析2000年1月至2007年12月我院首治的117例甲状腺微小乳头状癌病例,探讨患者的性别、年龄、病灶大小、有无完整包膜、是否为多发病灶、有无被膜外侵犯等临床因素与中央区淋巴结转移之间的关系.结果 有中央区淋巴结转移的共42例(35.9%),平均年龄为(40±9)岁,癌灶最大径中位数为0.75 cm;无转移的患者平均年龄为(45±10)岁,癌灶最大径中位数为0.70 cm;单因素及多因素分析均显示年龄及癌灶最大径与中央区淋巴结转移之间有显著相关性(P<0.05).分类树检验提示年龄≤43岁的患者中央区淋巴结转移率显著高于年龄>43岁者.性别、有无完整包膜、是否为多发病灶、有无被膜外侵犯等临床因素与中央区淋巴结转移无明显相关.结论 年龄≤43岁的甲状腺微小乳头状癌患者易出现中央区淋巴结转移,且随着癌灶增大转移的概率增大.

Clinical factors related to central compartment lymph node metastasis in papillary thyroid microcarcinoma: clinical analysis of 117 cases

Objective To analyze the correlation of central compartment lymph node metastasis (CCLNM) with different clinical factors of papillary thyroid microcarcinoma (PTMC). Methods 117 patients of PTMC,27 males and 90 females,aged 45 (16 - 68),underwent total thyroidectomy ( or lobectomy) and central compartment lymph node dissection with or without lateral neck dissection. The correlation of CCLNM with age,sex,tumor size,tumor capsule,multifocality,and extrathyroid extension was analyzed. Results CCLNM was found in 42 of the 117 patients with the mean age of 40 ± 9,significantly lower than that of the patients without CCLNM [(45 ± 10),P <0.05],and with the median tumor diameter of 0. 75 cm,significantly longer than that of the patients without CCLNM (0.70 cm,P <0.05). Both univariate and multivariate analyses showed that age and tumor size were significantly correlated with CCLNM (both P < 0. 05). Classification tree analysis showed that the CCLNM rate of the patients younger than 43 was significantly higher than that of the patients older than 43. Sex,tumor capsule,muhifocality,and extrathyroid extension were not associated with CCLNM. Conclusion CCLNM occurs more frequently in the PTMC patients who are younger than 43 years and in those who have larger tumor.