颈侧淋巴结阴性甲状腺乳头状微小癌中央区淋巴结转移的相关因素分析

目的：探讨颈侧淋巴结阴性（cN0）甲状腺乳头状微小癌（PTMC）中央区淋巴结转移相关的风险因素。方法收集首次行甲状腺切除手术及预防性中央区淋巴结清扫的cN0的PTMC患者392例，根据术后病理检查证实有无中央区淋巴结转移将患者分为两组，比较两组各种相关临床病理因素的差异。结果单因素分析显示：男性、年龄＜45岁、结节最大径＞7mm、总结节最大径（TTD）＞10mm的多灶性癌是中央区淋巴结转移的相关风险因素（P＜0.05或0.01）；多因素分析发现：男性、年龄＜45岁、结节最大径＞7mm、TTD＞10mm的多灶性癌也是中央区淋巴结转移的独立风险因素（P＜0.05或0.01）。结论男性、年龄＜45岁、结节最大径＞7mm、TTD＞10mm的多灶性癌的PTMC患者更易发生中央区淋巴结转移，对该类患者建议行中央区淋巴结清扫。

Risk factors of central lymph node metastasis in patients with cNo papillary thyroid microcarcinoma

Objective To investigate the risk factors associated with central lymph node metastasis in patients with clinical lateral cervical lymph node negative （cN0） papil ary thyroid microcarcinoma （PTMC）. Methods The clinical data of 392 patients with cN0 PTMC who underwent thyroidectomy and prophylactic central lymph node dissection in our hospital were collected. Ac-cording to the presence or absence of lymph node metastasis confirmed by postoperative pathologic examination, patients were divided into two groups, the clinicopathological features were compared between two groups. Results Univariate analysis showed that male, age〈45y, maximum tumor diameter〉7mm, multifocal carcinoma with total tumor diameter（TTD）〉10mm were related to the central lymph node metastasis （P〈0.05 or P〈0.01）. Multivariate analysis showed that male, age〈45y, maximum tumor diameter〉7mm, multifocal carcinoma with TTD〉10mm were independent risk factors for central lymph node metastasis （P〈0.05 or P〈0.01）. Conclusion Male PTMC patients aged〈45y, maximum tumor diameter〉7mm, multifocal carcinoma with TTD〉10mm are more susceptible to the central lymph node metastasis and prophylactic central lymphadenectomy is recom-mended for these patients.