目的:本研究旨在探讨甲状腺乳头状癌(PTC)侧颈淋巴结转移的危险因素。
方法:临床病理资料(年龄,性别,桥本甲状腺炎,术前循环肿瘤细胞(CTC),多焦点,最大病变直径,侵入胶囊,T级,和淋巴结转移)收集了2021年6月至2023年4月在梅州市人民医院诊断和治疗的830例PTC患者。分析侧颈淋巴结转移的相关因素。
结果:有334(40.2%),103例(12.4%)PTC患者有中央区淋巴结转移,和颈外侧淋巴结转移,分别。与无侧颈淋巴结转移的患者相比,伴侧颈淋巴结转移的PTC患者多灶性转移比例较高,最大病变直径>1cm,侵入胶囊,T3-T4阶段。回归logistic分析显示男性(比值比(OR):2.196,95%置信区间(CI):1.279-3.769,p=0.004),年龄<55岁(OR:2.057,95%CI:1.062-3.988,p=0.033),多焦(OR:2.759,95%CI:1.708-4.458,p<0.001),最大病变直径>1cm(OR:5.408,95%CI:3.233-9.046,p<0.001),T3-T4阶段(OR:2.396,95%CI:1.241-4.626,p=0.009),侵犯包膜(OR:2.051,95%CI:1.208-3.480,p=0.008)与颈外侧淋巴结转移有关。
结论:男性,年龄<55岁,多焦点,最大病变直径>1cm,T3-T4级,包膜侵犯是PTC侧颈淋巴结转移的独立危险因素。
OBJECTIVE: The aim of this study is to investigate the risk factors for lateral cervical lymph node metastasis in papillary thyroid carcinoma (PTC).
METHODS: Clinicopathological data (age, gender, Hashimoto\'s thyroiditis, preoperative circulating tumor cells (CTCs), multifocal, maximum lesion diameter, invaded capsule, T stage, and lymph node metastasis) of 830 PTC patients diagnosed and treated in Meizhou People\'s Hospital from June 2021 to April 2023 were collected. The related factors of lateral cervical lymph node metastasis were analyzed.
RESULTS: There were 334 (40.2%), and 103 (12.4%) PTC patients with central lymph node metastasis, and lateral cervical lymph node metastasis, respectively. Compared with patients without lateral cervical lymph node metastasis, PTC patients with lateral cervical lymph node metastasis had a higher proportion of multifocal, maximum lesion diameter > 1 cm, invaded capsule, T3-T4 stage. Regression logistic analysis showed that male (odds ratio (OR): 2.196, 95% confidence interval (CI): 1.279-3.769, p = 0.004), age < 55 years old (OR: 2.057, 95% CI: 1.062-3.988, p = 0.033), multifocal (OR: 2.759, 95% CI: 1.708-4.458, p < 0.001), maximum lesion diameter > 1 cm (OR: 5.408, 95% CI: 3.233-9.046, p < 0.001), T3-T4 stage (OR: 2.396, 95% CI: 1.241-4.626, p = 0.009), and invaded capsule (OR: 2.051, 95% CI: 1.208-3.480, p = 0.008) were associated with lateral cervical lymph node metastasis.
CONCLUSIONS: Male, age < 55 years old, multifocal, maximum lesion diameter > 1 cm, T3-T4 stage, and invaded capsule were independent risk factors for lateral cervical lymph node metastasis in PTC.