摘要
目的 分析单侧甲状腺乳头状癌(PTC)伴对侧腺叶结节合并隐匿性癌的危险因素.方法 回顾性分析2021 年 1 月至 2022 年 9 月广东医科大学附属医院收治的 114 例术前诊断为单侧PTC伴对侧腺叶结节患者的临床资料,所有患者均行甲状腺全切除术或近全切除术+中央区淋巴结清扫术(部分同时进行颈侧区淋巴结清扫术).分析单侧PTC伴对侧腺叶结节合并隐匿性癌的危险因素.结果 术后病理检查结果显示,单侧PTC伴对侧腺叶结节合并隐匿性癌 30 例,无隐匿性癌84 例.单因素分析结果显示,两组的PTC肿瘤直径、合并淋巴结转移占比、合并腺体外侵犯占比比较,差异具有统计学意义(P<0.05).多因素Logistic回归分析结果显示,合并淋巴结转移、合并腺体外侵犯是影响单侧PTC伴对侧腺叶结节合并隐匿性癌的独立危险因素(P<0.05).结论 淋巴结转移及腺体外侵犯是单侧PTC伴对侧腺叶结节合并隐匿性癌的独立危险因素;针对术前诊断为单侧PTC合并对侧腺叶结节,若存在淋巴结转移及腺体外侵犯等恶性特征,应该行甲状腺全切术治疗.
Abstract
Objective To analyze the risk factors analysis of occult carcinoma in contralateral lobular nodules for unilateral papillary thyroid carcinoma(PTC).Methods The clinical data of 114 patients with unilateral PTC and contralateral lobular nodules admitted from January 2021 to September 2022 in the Affiliated Hospital of Guangdong Medical University were retrospectively analyzed.All patients underwent total thyroidectomy or near total thyroidectomy plus central lymph node dissection(some also underwent cervical lymph node dissection).The risk factors of occult carcinoma in contralateral lobular nodules for unilateral PTC were analyzed.Results The results of postoperative pathological examination showed that there were 30 cases with occult carcinoma in contralateral lobular nodules for unilateral PTC and 84 cases without occult carcinoma.The results of univariate analysis showed that there were statistically significant differences in the PTC tumor diameter,the proportion of lymph node metastasis and the proportion of extrandular invasion between the two groups(P<0.05).Multivariate Logistic regression analysis showed that lymph node metastasis and extrandular invasion were independent risk factors for occult carcinoma in contralateral lobular nodules for unilateral PTC(P<0.05).Conclusion Lymph node metastasis and extrandular invasion are independent risk factors for occult carcinoma in contralateral lobular nodules for unilateral PTC.For unilateral PTC with contralateral lobular nodules diagnosed before surgery,total thyroidectomy should be performed if there are malignant features such as lymph node metastasis and extrandular invasions.
NETL
NSTL
维普
万方数据