摘要
目的观察老年甲状腺乳头状癌(papillary thyroid cancer,PTC)患者的随访结局,分析中央区及颈侧区淋巴结转移的影响因素。方法回顾性分析2016年2月—2020年8月于河北北方学院附属第一医院诊治的151例老年PTC患者的临床资料,根据术后淋巴结转移情况,分为对照组(无转移组,n=69)、中央转移组(单纯中央区转移,n=48)和颈侧转移组(颈侧转移,n=34)。收集3组基线资料及随访资料,使用无序多分类Logistic回归模型,探索中央区及颈侧区淋巴结转移的影响因素。结果单因素分析显示,性别、肿瘤大小、多发灶、合并桥本、肿瘤纵横比、钙化情况、回声情况、包膜侵犯情况在3组间差异具有统计学意义(P<0.05)。多因素分析显示,肿瘤直径超过1 cm(OR=2.471,95%CI=1.135~5.409)、结节钙化(OR=1.887,95%CI=1.032~3.451)和包膜侵犯(OR=2.144,95%CI=1.842~5.457)是老年PTC患者中央区淋巴结转移的危险因素;肿瘤直径超过1 cm(OR=2.536,95%CI=1.196~6.768)和包膜侵犯(OR=2.136,95%CI=1.187~3.602)是老年PTC患者颈侧区淋巴结转移的危险因素。结论多种因素与老年PTC患者中央区及颈侧区淋巴结转移有关,肿瘤直径超过1 cm、结节钙化和包膜侵犯是中央区淋巴结转移的危险因素,肿瘤直径超过1 cm、包膜侵犯病灶的范围越广,颈侧区淋巴结转移的可能性越大。
Objective To observe the follow-up outcomes of elderly patients with papillary thyroid cancer(PTC),and analyze the influencing factors of lymph node metastasis in the central and lateral cervical regions.Methods The clinical data of 151 elderly patients with PTC who were diagnosed and treated in First Affiliated Hospital of Hebei North University from February 2016 to August 2020 were retrospectively analyzed.According to the postoperative lymph node metastasis,they were divided into control group(without metastasis,n=69),central metastasis group(simple central metastasis,n=48)and lateral cervical metastasis group(lateral cervical metastasis,n=34).The baseline data and follow-up data of the three groups were collected,and the unordered multiclass logistic regression model was used to explore the influencing factors of lymph node metastasis in the central and lateral cervical regions.Results Univariate analysis showed that there were significant differences in gender,tumor size,multiple foci,combined Hashimoto,tumor aspect ratio,calcification,echo and capsular invasion among the three groups(P<0.05).Multivariate analysis showed that tumor diameter over 1 cm(OR=2.471,95%CI=1.135-5.409),nodular calcification(OR=1.887,95%CI=1.032—3.451)and capsular invasion(OR=2.144,95%CI=1.842-5.457)were the risk factors of lymph node metastasis in the central region in elderly patients with PTC;tumor diameter over 1 cm(OR=2.536,95%CI=1.196-6.768)and capsular invasion(OR=2.136,95%CI=1.187-3.602)were the risk factors of lymph node metastasis in the lateral cervical region in elderly patients with PTC.Conclusion Many factors are related to lymph node metastasis in the central and lateral cervical regions of elderly patients with PTC.Tumor diameter over 1 cm,nodular calcification and capsular invasion are the risk factors of lymph node metastasis in the central region.The tumor diameter over 1 cm and the wider the capsular invasion is,the greater the possibility of lymph node metastasis in the lateral cervical region.
作者
解琪
辛运超
李栋
刘亚超
尚小领
Xie Qi;Xin Yunchao;Li Dong;Liu Yachao;Shang Xiaoling(Department of Otolaryngology,Head and Neck Surgery,First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei,075061,P.R.China)
出处
《老年医学与保健》
CAS
2022年第2期343-348,共6页
Geriatrics & Health Care
基金
2020年政府资助临床医学优秀人才项目(冀财预复[2020]397号)。
关键词
老年
甲状腺乳头状癌
影响因素
淋巴结转移
预测价值
elderly
papillary thyroid carcinoma
influencing factors
lymph node metastasis
predictive value
