摘要
目的探讨T1/T2期临床淋巴结阴性（cN0）PTC合并桥本病（Hashimoto’s thyroiditis，HT）患者中央区淋巴结转移的特点及高危因素。方法回顾性分析中国医科大学附属第一医院普通外科398例T1／T2期cN0PTC同期行中央淋巴结清扫患者的临床资料，将患者分为PTC合并HT组（病例组）及PTC组（对照组），比较2组的临床病理特点，并对2组中央区淋巴结转移的高危因素进行分析。结果398例中有98例（24．6％）合并HT。2组间中央区淋巴结转移率相近（40．8％VS41．3％），病例组清扫淋巴结总数明显高于对照组（4．9vs2．9，P〈0．01），2组间转移淋巴结个数没有差异（1．0vs1．0）。单因素分析显示，病例组中，肿瘤直径〉1cm与中央区淋巴结转移明显相关（P〈0．01）；对照组中，男性、年龄〈45岁、肿瘤直径〉1cm及肿瘤位于腺叶中下极与中央区淋巴结转移明显相关（P〈0．01）。多因素分析显示，病例组中肿瘤直径〉1cm是中央区淋巴结转移的独立危险因素，而对照组中男性、年龄〈45岁、肿瘤直径〉1cm及肿瘤位于腺叶中下极均是中央区淋巴结转移的独立危险因素。结论T1/T2期cNOPTC合并HT中央区淋巴结总数较多，但转移淋巴结个数与单纯PTC相比并无差异，建议对肿瘤直径〉1cm患者常规行中央区淋巴结清扫。
Objective To investigate the characteristics and risk factors of central lymph node metastasis in clinically node negative （cN0）papillary thyroid carcinoma （PTC）（T1 or T2 stage）coexisting with Hashimoto＇s thyroiditis （HT）. Methods A total of 398 patients undergoing thyroidectomy with central lymph node dissection were enrolled in the study. Patients were divided into the trial group （FFC with HT）and the control group （PTC without HT）. The difference of the clinicopathological characteristics between the 2 groups and risk factors for central lymph node metastasis were analyzed. Results Among the total 398 patients, 98 （24.6%）had coexistent HT. Central lymph node metastasis rate was similar in the 2 groups （40.8% vs 41.3%）. The number of dissected central lymph nodes was significantly more in the trial group than in the control group （4.9 vs 2.9, P〈0.01） while the number of metastatic lymph nodes had no statistical significance between the 2 groups （1.0 vs 1.0）. Univariate analysis showed that tumor size〉l cm was significantly associated with central lymph node metastasis in the trial group （P〈0.01）. Male, 〈45 years, tumor size〉l cm, and tumor located in the middle/lower third of lobe were all significantly associated with central lymph node metastasis in the control group （P〈0.01）. Multivariate analysis showed that tumor size〉l cm was independent predictor for central lymph node metastasis in the trial group, while female, 〈45 years, tumor size〉l cm, and tumor located in the middle/lower third of lobe were all independent predictors for central lymph node metastasis in the control group. Conclusions The number of central lymph nodes was larger in cN0 PTC coexisting with HT patients than that in PTC patients, but there was no statistical difference in the number of metastatic lymph nodes between cN0 PTC with and without HT. Central lymph node dissection is recommended when tumor size 1 cm in cN0 PTC coexisting with HT patients.
出处
《中华内分泌外科杂志》
CAS
2016年第1期41-44,共4页
Chinese Journal of Endocrine Surgery
关键词
甲状腺乳头状癌
桥本病
中央区淋巴结
Papillary thyroid carcinoma
Hashimoto＇s thyroiditis
Central lymph nodes
