摘要
目的探讨伴同侧颈侧区淋巴结转移(LLNM)的单侧甲状腺乳头状癌(PTC)患者对侧中央区淋巴结(Cont-CLNs)转移的影响因素。方法选取2018年7月至2022年7月江苏省原子医学研究所附属江原医院收治的LLNM-PTC患者127例,根据其是否发生Cont-CLNs转移,分成转移组(n=68)和非转移组(n=59)。收集患者的资料,包括性别、年龄、肿瘤大小、肿瘤回声、血流信号、有无微钙化、肿瘤数量、病变腺叶、结节性甲状腺囊肿、被膜侵犯、有无桥本甲状腺炎以及患侧中央区淋巴结、气管前淋巴结与喉前淋巴结转移发生率与术后并发症情况。采用二元logistic回归模型分析LLNM-PTC患者发生Cont-CLNs转移的影响因素。采用SPSS 20.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ^(2)检验。结果转移组男性、微钙化、多发性肿瘤、被膜侵犯占比分别为75.00%(51/68)、47.06%(32/68)、55.88%(38/68)、47.06%(32/68),高于非转移组的37.29%(22/59)、16.95%(10/59)、18.64%(11/59)、15.25%(9/59),且转移组肿瘤最大径大于非转移组(P<0.05)。转移组患侧中央区淋巴结、气管前淋巴结、喉前淋巴结转移率分别为51.47%(35/68)、44.12%(30/68)、50.00%(34/68),高于非转移组的20.34%(12/59)、15.25%(9/59)、16.95%(10/59),差异有统计学意义(P<0.05)。二元logistic回归分析显示,男性、肿瘤太大、微钙化、多发性肿瘤、被膜侵犯、患侧中央区淋巴结转移、气管前淋巴结转移、喉前淋巴结转移是患者发生Cont-CLNs转移的独立危险因素,差异有统计学意义(P<0.05)。结论LLNM-PTC患者发生Cont-CLNs转移受多种因素影响,包括性别、肿瘤大小、微钙化、肿瘤数量、被膜侵犯以及患侧中央区、气管前、喉前的淋巴结转移,日后诊疗中需引起重视。
Objective To investigate the influencing factors of contralateral central lymph node(Cont-CLNs)metastasis in patients with unilateral papillary thyroid carcinoma(PTC)with ipsilateral cervical lymph node metastasis(LLNM).Methods A total of 127 LLNM-PTC patients admitted to Jiangyuan Hospital Affiliated to Jiangsu Institute of Atomic Medicine from July 2018 to July 2022 were selected and divided into metastasis group(n=68)and non-metastasis group(n=59)according to whether they had Cont-CLNs metastasis.Data of the patients were collected,including gender,age,tumor size,tumor echo,blood flow signal,microcalcification,tumor number,pathological gland lobe,nodular thyroid cyst,capsule invasion,Hashimoto′s thyroiditis,incidence of central lymph node,pretracheal lymph node and prelaryngeal lymph node metastasis and postoperative complications.Binary logistic regression model was used to analyze the factors influencing the occurrence of Cont-CLNs metastasis in LLNM-PTC patients.SPSS statistics 20.0 was used for statistical analysis.Data comparison between two groups was perfomed using t test orχ^(2) test depending on data type.Results In the metastasis group,the proportion of male,microcalcification,multiple tumor and capsule invasion was 75.00%(51/68),47.06%(32/68),55.88%(38/68)and 47.06%(32/68),respectively.It was higher than that in the non-metastasis group 37.29%(22/59),16.95%(10/59),18.64%(11/59),15.25%(9/59),and the maximum tumor diameter in the metastat group was greater than that in the non-metastasis group(P<0.05).The metastasis rates of central lymph nodes,pretracheal lymph nodes and prelaryngeal lymph nodes were 51.47%(35/68),44.12%(30/68)and 50.00%(34/68),respectively.It was higher than 20.34%(12/59),15.25%(9/59)and 16.95%(10/59)in non-metastasis group(P<0.05).Binary logistic regression analysis showed that male,tumor size,microcalcification,multiple tumors,capsule invasion,central lymph node metastasis on the affected side,pretractal lymph node metastasis,and prelaryngeal lymph node metastasis were independent risk factors for Cont-CLNs metastasis,and the difference was statistically significant(P<0.05).Conclusion The occurrence of Cont-CLNs metastasis in LLNM-PTC patients is affected by multiple factors,including gender,tumor size,microcalcification,tumor number,capsule invasion,and lymph node metastasis in the central region of the affected side,pretracheal and prelaryngeal area,which deserves attention clinically.
作者
程剑峰
周琰
汤铖
黄政坤
Cheng Jianfeng;Zhou Yan;Tang Cheng;Huang Zhengkun(Department of Surgery,Jiangyuan Hospital Affiliated to Jiangsu Institute of Atomic Medicine,Wuxi 214000,Jiangsu Province,China;Department of Anesthesiology,Jiangyuan Hospital Affiliated to Jiangsu Institute of Atomic Medicine,Wuxi 214000,Jiangsu Province,China)
出处
《中华老年多器官疾病杂志》
2024年第1期54-58,共5页
Chinese Journal of Multiple Organ Diseases in the Elderly
关键词
甲状腺乳头状癌
颈侧区淋巴结转移
对侧中央区淋巴结转移
影响因素
papillary thyroid carcinoma
cervical lymph node metastasis
contralateral central lymph node metastasis
influencing factors
