青少年甲状腺乳头状癌的临床病理特征及预后分析
Clinicopathological characteristics and prognosis of papillary thyroid cancer in adolescents
孙玉霄 1刘维豪 1张逸菲 1李红强 1唐艺峰 1殷德涛2
作者信息
- 1. 郑州大学第一附属医院甲状腺外科(郑州 450052)
- 2. 郑州大学第一附属医院甲状腺外科(郑州 450052);河南省甲状腺癌多学科诊疗工程研究中心(郑州 450052);河南省甲状腺癌医学重点实验室(郑州 450052)
- 折叠
摘要
目的 总结青少年甲状腺乳头状癌(papillary thyroid,PTC)的临床病理特征并且探索影响颈侧区淋巴结转移及预后的危险因素.方法 回顾性收集2012年1月至2022年1月期间郑州大学第一附属医院甲状腺外科收治且符合纳入和排除标准的150例青少年PTC患者为研究对象(青少年组),并选择100例同期就诊的成人PTC患者为成人组.采用SPSS 25.0软件进行统计学分析,比较2组患者的临床病理特征,并分别采用logistic回归和Cox比例风险回归模型探索青少年PTC患者颈侧区淋巴结转移及复发的危险因素.结果 青少年PTC患者更易发生腺体外侵犯[(30.0％(45/150)比17.0％(17/100),P=0.020]、颈部淋巴结转移[79.3％(119/150)比 48.0％(48/100),P＜0.001]、中央区淋巴结转移[78.7％(118/150)比 48.0％(48/100),P＜0.001]和颈侧区淋巴结转移[44.0％(66/150)比12.0％(12/100),P＜0.001];并且青少年PTC患者的最大肿瘤直径更大(1.75 cm 比 0.75 cm,P＜0.001),最大肿瘤直径＞2 cm 的比例更高[45.3％(68/150)比 8.0％(8/100),P＜0.001].在青少年PTC患者中,腺体外侵犯(OR=2.654,P=0.022)、多病灶(OR=4.860,P＜0.001)和最大肿瘤直径＞2 cm(OR=3.845,P=0.001)为颈侧区淋巴结转移的危险因素;颈侧区淋巴结转移(RR=10.105,P=0.040)和远处转移(RR=7.058,P=0.003)是青少年PTC患者术后复发的预测因素.结论 与成人PTC患者相比,青少年PTC患者的肿瘤侵袭性较强;存在腺体外侵犯、多病灶和最大肿瘤直径＞2 cm的青少年PTC需考虑是否行颈侧区淋巴结清扫术;存在颈侧区淋巴结转移和远处转移的青少年PTC患者需密切关注其复发状况.
Abstract
Objective To summarize the clinicopathological characteristics of papillary thyroid cancer(PTC)in adolescents and analyze the risk factors affecting lateral lymph node metastasis and prognosis.Methods In retrospectively,150 adolescent PTC patients admitted to the Department of Thyroid Surgery of the First Affiliated Hospital of Zhengzhou University from January 2012 to January 2022 and meeting the inclusion and exclusion criterias were collected as the study subjects(adolescent group),and 100 adult PTC patients were selected as adult group.Statistical analysis was performed with SPSS 25.0 software to compare the clinicopathological characteristics of the patients in the two groups,and to explore the risk factors for lateral lymph node metastasis and recurrence in adolescent PTC patients by using logistic regression and Cox proportional hazards regression models,respectively.Results Adolescents with PTC were more prone to extrandular invasion[30.0％(45/150)versus 17.0％(17/100),P=0.020],neck lymph node metastasis[79.3％(119/150)versus 48.0％(48/100),P＜0.001],central lymph node metastasis[78.7％(118/150)versus 48.0％(48/100),P＜0.001],lateral lymph node metastasis[44.0％(66/150)versus 12.0％(12/100),P＜0.001];and had a greater maximum tumor diameter(1.75 cm versus 0.75 cm,P＜0.001)and higher ratio of greater maximum tumor diameter＞2 cm[45.3％(68/150)versus 8.0％(8/100),P＜0.001]in adolescent PTC patients.In adolescent PTC patients,extraglandular invasion(OR=2.654,P=0.022),multifoci(OR=4.860,P＜0.001)and maximum tumor diameter＞2 cm(OR=3.845,P=0.001)were risk factors for lateral lymph node metastasis;lateral lymph node metastasis(RR=10.105,P=0.040)and distant metastasis(RR=7.058,P=0.003)were predictors of postoperative recurrence in adolescent PTC patients.Conclusions Compared with adult PTC patients,adolescent PTC patients have more aggressive tumors.Adolescent PTC with extraglandular invasion,multilesions,and maximum tumor diameter＞2 cm should be considered for lateral lymph node dissection;and adolescent PTC patients with lateral lymph node metastasis and distant metastasis should pay close attention to their recurrence status.
关键词
甲状腺乳头状癌/青少年/颈侧区淋巴结转移/复发Key words
papillary thyroid cancer/adolescent/lateral lymph node metastasis/recurrence引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据