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甲状腺乳头状癌术后颈侧区复发影响因素分析

A research of the current status and influencing factors of postoperative lateral lymph node recurrence in patients with papillary thyroid carcinoma

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目的 分析甲状腺乳头状癌术后颈侧区复发的相关影响因素.方法 回顾性分析2018年1月~2022年12月我院经手术治疗的1 229例甲状腺乳头状癌病人的临床及病理资料.结果 1 229例病人中,术后复发70例,术后无复发1159例;经多因素Cox比例风险回归分析,肿瘤直径(HR:0.497,95%CI:0.287~0.858)、原发肿瘤个数(HR:2.037,95%CI:1.209~3.433)、侵犯包膜(HR:0.476,95%CI:0.251~0.903)、包膜外侵犯(HR:0.332,95%CI:0.169~0.657)可能是甲状腺乳头状癌病人术后颈侧区复发的影响因素.中央组淋巴结转移比例在多因素Cox风险比例回归分析中具有较好的预测价值(P<0.05),ROC曲线确定中央组淋巴结转移比例切点值为23.6%.结论 对于接受过手术治疗的甲状腺乳头状癌病人,多个原发灶、肿瘤直径>1 cm、有包膜或包膜外侵犯是甲状腺乳头状癌术后颈侧区复发的风险因素.中央组淋巴结转移比例≥23.6%,对术后颈侧区复发的风险有良好的预示作用.
Objective To investigate the postoperative lateral lymph node recurrence of papillary thyroid carcinoma(PTC)and its related factors.Methods The clinical and pathological data of 1 229 patients with papillary thyroid carcinoma who underwent surgery in Xiangyang Central Hospital from January 1,2018 to December 31,2022 were retrospectively collected.Results A total of 1229 patients'data were obtained,including 70 patients in the recurrence group and 1159 patients in the non-recurrence group.Multivariate COX proportional hazards regression analysis showed that tumor size(HR:0.497,95%CI:0.287-0.858),the number of primary tumors(HR:2.037,95%CI:1.209-3.433),capsular invasion(HR:0.476,95%CI:0.251-0.903),extracapsular invasion(HR:0.332,95%CI:0.169-0.657)were the influencing factors of postoperative recurrence in patients with papillary thyroid carcinoma.The proportion of central lymph node metastasis had a good predictive value in multivariate COX regression analysis(P<0.05),and the cut-off value of the proportion of central lymph node metastasis determined by ROC curve was 23.6%.Conclusions Multiple primary lesions,tumor size>1 cm,capsular or extracapsular extension are risk factors for recurrence of papillary thyroid carcinoma after surgery.In clinical practice,the proportion of central lymph node metastasis ≥23.6%has a good predictive effect on the risk of postoperative lateral lymph node recurrence.

papillary thyroid carcinomapostoperative recurrencerisk factorscentral lymph node metastasis

向悦、陈德杰

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430081 武汉科技大学医学部医学院

湖北文理学院附属襄阳市中心医院甲状腺乳腺外科

甲状腺乳头状癌 术后复发 危险因素 中央组淋巴结转移

2024

临床外科杂志
中华医学会湖北分会

临床外科杂志

CSTPCD
影响因子:0.716
ISSN:1005-6483
年,卷(期):2024.32(3)
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