【摘要】：目的:探討1988例甲狀腺微小乳頭狀癌(PTMC)頸部中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移的危險(xiǎn)因素。方法:回顧性分析新疆醫(yī)科大學(xué)附屬腫瘤醫(yī)院2010-01-2016-03期間初治的PTMC癌患者的臨床病理特征,通過(guò)χ~2檢驗(yàn)、多因素統(tǒng)計(jì)分析,探討頸部中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移的危險(xiǎn)因素。結(jié)果:頸部中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移率為34.9%。單因素分析顯示,確診年齡45歲、男性、多灶、腫瘤位于雙側(cè)腺葉(含峽部)、腫瘤直徑5mm、包膜浸潤(rùn)、包膜外侵犯是頸部中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移的危險(xiǎn)因素(P0.05);多因素分析顯示,男性、確診年齡45歲、腫瘤直徑5mm、包膜浸潤(rùn)、包膜外侵犯是影響頸部中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移的獨(dú)立危險(xiǎn)因素。腫瘤位置是單灶頸部中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移的獨(dú)立危險(xiǎn)因素,其中單灶位于腺葉下極者中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移率最高(46.8%);而多灶腫瘤位置與中央?yún)^(qū)淋巴結(jié)轉(zhuǎn)移無(wú)關(guān)(P0.05)。結(jié)論:當(dāng)PTMC患者存在以下情況:男性、確診年齡45歲、腫瘤直徑5mm、包膜浸潤(rùn)、包膜外侵犯,單灶位于腺葉下極時(shí),應(yīng)警惕淋巴結(jié)轉(zhuǎn)移可能,建議行積極診治方案以及更加密切的術(shù)后隨訪。
[Abstract]:Objective: to investigate the risk factors of (PTMC) cervical lymph node metastasis in 1988 cases of thyroid micropapillary carcinoma. Methods: the clinicopathological features of patients with PTMC cancer were analyzed retrospectively from 2010-01-2016-03 in the affiliated Cancer Hospital of Xinjiang Medical University. The risk factors of cervical lymph node metastasis were analyzed by 蠂 ~ 2 test and multivariate statistical analysis. Results: the lymph node metastasis rate in the central region of the neck was 34. 9%. Univariate analysis showed that the age of diagnosis was 45 years old, male with multiple foci, the tumor was located in bilateral lobes of gland (including isthmus), the diameter of tumor was 5mm, the invasion of capsule and extracapsular invasion were the risk factors of lymph node metastasis in the central region of neck (P0.05). The age of diagnosis was 45 years old, tumor diameter was 5 mm, capsule invasion and extracapsular invasion were independent risk factors for cervical lymph node metastasis. The location of tumor was an independent risk factor for lymph node metastasis in the central region of the single focus neck, in which the rate of lymph node metastasis in the central region was the highest (46.8%) in the case of the single focus located in the inferior lobe of the gland, while the location of the multi-focus tumor was not related to the lymph node metastasis in the central region (P0.05). Conclusion: when PTMC patients have the following conditions: male, the age of diagnosis is 45 years, tumor diameter is 5mm, capsule infiltration, extracapsular invasion, single focus is located in the inferior lobe of gland, lymph node metastasis may be possible. It is suggested that active treatment and more closely follow-up should be carried out.
【作者單位】： 新疆醫(yī)科大學(xué)附屬腫瘤醫(yī)院乳腺頭頸外科;
【基金】：新疆醫(yī)科大學(xué)研究生創(chuàng)新創(chuàng)業(yè)項(xiàng)目(No:CXCY039)
【分類號(hào)】：R736.1

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