甲状腺乳头状癌跳跃性侧颈区淋巴结转移的危险因素分析

目的探究甲状腺乳头状癌（PTC）颈部淋巴结跳跃性转移的临床病理特征及其危险因素。 方法回顾性分析2015年7月至2018年11月福建医科大学附属协和医院收治的259例PTC患者临床资料，探究跳跃性侧颈区淋巴结转移的危险因素。 结果PTC颈部淋巴结跳跃性转移的发生率为9.3%（24/259）。单因素分析显示，中央区淋巴结清扫数目在跳跃性转移组中更少（P=0.031）；肿瘤最大径<1 cm（P<0.001）及肿瘤位于腺体上部（P=0.012）与PTC患者跳跃性转移的发生有关。多因素分析显示，肿瘤最大径<1 cm（OR=5.934，P<0.001）和肿瘤位于腺体上部（OR=2.812，P=0.023）是PTC患者颈部淋巴结跳跃性转移的独立危险因素。 结论肿瘤最大径<1 cm和肿瘤位于腺体上部的PTC患者侧颈区淋巴结更易发生跳跃性转移。

Risk factors of skip lateral lymph node metastasis leaping over the central compartment in papillary thyroid carcinoma

Objective To investigate the clinicopathological features and risk factors of skip metastasis to the lateral compartment without central lymph node metastasis in papillary thyroid carcinoma(PTC).Methods The medical records of two hundred and fifty-nine patients with PTC who met inclusion criteria in Fujian Medical University Union Hospital from July 2015 to November 2018 were retrospectively analyzed for the risk factors of skip lateral lymph node metastasis.Results The frequency of skip lymph node metastasis was approximately 9.3%(24/259).Univariate analysis showed that the skip metastasis group showed a lower harvested central lymph node number(P=0.031).In addition,skip metastasis was significantly associated with primary tumor size<1 cm(P<0.001)and tumor location in the upper portion of the thyroid(P=0.012).Multivariate analysis showed that primary tumor size<1 cm(OR=5.934,P<0.001)and tumor location in the upper portion of the thyroid(OR=2.812,P=0.023)were the independent risk factors of skip metastasis.Conclusion Skip metastasis in PTC is more likely in patients with tumor size<1 cm and tumor location in the upper portion of the thyroid.