摘要
目的研究德尔法淋巴结转移与甲状腺乳头状癌患者临床病理特征及CD34、ESM-1表达的关系。方法以2018年1月至2020年6月进行治疗的206例甲状腺乳头状癌患者作为研究对象,德尔法淋巴结阳性患者35例,德尔发淋巴结阴性患者171例,比较两组患者的临床病理特征、CD34、ESM-1表达水平之间的差异,研究DLN阳性的危险因素。结果两组患者的肿瘤直径、多灶性、桥本氏甲状腺炎、颈部中央区淋巴结清扫数目、颈部中央区淋巴结转移数目之间的差异无统计学意义(P>0.05),DLN阳性组患者的颈部侧区淋巴结清扫数目、颈部侧区淋巴结转移数目显著低于DLN阴性组,DLN阳性组患者被膜侵犯率以及中央肿瘤位置率显著高于DLN阴性组,差异有统计学意义(P<0.05);DLN阳性组患者的CD34、ESM-1表达水平显著高于DLN阴性组,差异有统计学意义(P<0.05);通过logistics多因素分析,被膜侵犯、肿瘤位置为中央、较低的颈部侧区淋巴结清扫数目、颈部侧区淋巴结转移数目均是造成患者DLN阳性的危险因素。结论被膜侵犯、肿瘤位置为中央、较低的颈部侧区淋巴结清扫数目、颈部侧区淋巴结转移数目均属于德尔法淋巴结阳性的危险因素,建议针对德尔法阳性甲状腺乳头状癌患者,采取甲状腺全切手术对于手术的彻底性具有积极的意义。
Objective To study the correlations between Delphic lymph node metastasis and clinicopathological features and expression of CD34 and ESM-1 in patients with papillary thyroid carcinoma.Methods In this prospective study,206 patients with thyroid papillary carcinoma treated in our hospital from January 2018 to June 2020 were selected,including 35 patients with positive deladal lymph node and 171 patients with negative deladal lymph node.The differences in clinicopathological features,CD34 and ESM-1 expression levels between the two groups were compared.Results The differences in tumor diameter,multifocality,Hashimoto′s thyroiditis,number of central compartment lymph node dissections,and number of central compartment lymph node metastases between the two groups of patients were not statistically significant(P>0.05).The number of lateral compartment lymph node dissections and lateral compartment lymph node metastases in the DLN-positive group were significantly lower than those in the DLN-negative group,and the rates of capsule invasion and central tumor location in the DLN-positive group were significantly higher than those in the DLN-negative group,with statistical significance(P<0.05).The expression levels of CD34 and ESM-1 in the DLN-positive group were significantly higher than those in the DLN-negative group,with statistical significance(P<0.05).Through logistic regression analysis,capsule invasion,central tumor location,lower number of lateral compartment lymph node dissections,and lateral compartment lymph node metastases were identified as risk factors for DLN positivity.Conclusion Capsule invasion,central tumor location,lower number of lateral compartment lymph node dissections,and lateral compartment lymph node metastases are risk factors for DLN positivity.For patients with DLN-positive papillary thyroid carcinoma,total thyroidectomy is recommended as it is a more thorough surgical approach.
作者
辛运超
孙晓冉
尚小领
魏东
李栋
XIN Yun-chao;SUN Xiao-ran;SHANG Xiao-ling;WEI Dong;LI Dong(Department of Ear,Nose,Throat,Head and Neck Surgery,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China;不详)
出处
《广东医学》
CAS
2023年第7期847-851,共5页
Guangdong Medical Journal
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)
张家口市科学技术与研究发展计划项目(1811032D-8)。
