本文選題：甲狀腺微小乳頭狀癌 + 中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移　； 參考：《中國(guó)實(shí)用外科雜志》2017年09期

【摘要】：目的探討甲狀腺微小乳頭狀癌(PTMC)臨床病理學(xué)特征及中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移(CLNM)危險(xiǎn)因素;尤其探討不同年齡截點(diǎn)下,確診年齡與CLNM相關(guān)性,闡述確診年齡實(shí)際意義。方法回顧性分析新疆醫(yī)科大學(xué)附屬腫瘤醫(yī)院2010年1月至2016年3月初治的1988例PTMC病人臨床病理學(xué)特征,通過(guò)χ2檢驗(yàn)、ROC曲線及多因素統(tǒng)計(jì)分析,探討CLNM危險(xiǎn)因素。又將25~70歲年齡區(qū)間中每5歲及30~60歲年齡區(qū)間中每歲為年齡截點(diǎn),分別探討不同年齡截點(diǎn)下,確診年齡與PTMC中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移相關(guān)性。結(jié)果 CLNM發(fā)生率為34.9%,且其隨確診年齡增加而明顯下降。除70歲截點(diǎn)外,25~70歲年齡區(qū)間中每5歲及30~60歲年齡區(qū)間中每歲為截點(diǎn)差異均有統(tǒng)計(jì)學(xué)意義(P0.05),即上述確診年齡截點(diǎn)均可提示確診年齡是CLNM獨(dú)立危險(xiǎn)因素。多因素分析顯示,男性、腫瘤數(shù)目≥3枚、腫瘤直徑5 mm、單灶位于下極、包膜浸潤(rùn)是影響CLNM發(fā)生的獨(dú)立危險(xiǎn)因素(P0.05)。結(jié)論確診年齡是PTMC中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移獨(dú)立危險(xiǎn)因素,但其僅反映CLNM風(fēng)險(xiǎn)變化趨勢(shì),無(wú)確定截點(diǎn);將年齡看成連續(xù)型變量,在相關(guān)研究結(jié)果闡述中更加合理。其次,當(dāng)PTMC存在以下情況,如男性、腫瘤數(shù)目≥3枚、腫瘤直徑5 mm、單灶位于下極、包膜浸潤(rùn),應(yīng)警惕CLNM可能。
[Abstract]:Objective to investigate the clinicopathological features and risk factors of central lymph node metastasis (CLNM) in thyroid micropapillary carcinoma, especially to explore the correlation between the age of diagnosis and CLNM at different age points, and to elucidate the practical significance of the age of diagnosis. Methods the clinicopathological characteristics of 1988 patients with PTMC treated in Cancer Hospital affiliated to Xinjiang Medical University from January 2010 to early March 2016 were analyzed retrospectively. The risk factors of CLNM were analyzed by 蠂 2 test and multivariate statistical analysis. At the same time, every 5 years and 30 ~ 60 years old of 2570 years old were regarded as the age cutoff points, and the correlation between the diagnosis age and the lymph node metastasis in the central area of PTMC was studied respectively under different age cutoff points. Results the incidence of CLNM was 34.9, and it decreased with the age of diagnosis. There was significant difference between every 5 years old and 30 ~ 60 years old in every 5 years old and 30 ~ 60 years old except 70 years old cut point, which indicated that the diagnosis age was an independent risk factor of CLNM. Multivariate analysis showed that in male, the number of tumors was more than 3, the diameter of tumor was 5 mm, the single focus was located at the lower pole, and the capsule invasion was an independent risk factor for the occurrence of CLNM (P 0.05). Conclusion the age of diagnosis is an independent risk factor for lymph node metastasis in the central region of PTMC, but it only reflects the trend of CLNM risk change and has no definite cut-off point. The age is regarded as a continuous variable, which is more reasonable in the elaboration of relevant research results. Secondly, when PTMC exists the following conditions, such as male, the number of tumor 鈮，

本文編號(hào)：1808607