摘要
目的 探讨多灶性甲状腺微小乳头状癌喉前、气管前、气管旁淋巴结转移的危险因素.方法 回顾性分析2023年2月至2024年4月北京大学肿瘤医院内蒙古医院收治的629例甲状腺微小乳头状癌患者的临床资料,统计颈部中央区淋巴结转移的情况,分析相关因素与中央区淋巴结亚区的关系.结果 单因素分析结果显示,性别、年龄、肿瘤直径、是否合并桥本甲状腺炎与气管旁淋巴结转移均有关(均P＜0.05);被膜侵犯与气管前和气管旁淋巴结有关(P＜0.05);性别、数量与喉前淋巴结转移有关(均P＜0.05).多因素分析结果显示,男性、年龄＜55岁、被膜侵犯是气管旁淋巴结转移的独立危险因素(x2=8.331,P=0.004;x2=9.139,P=0.003;x2=4.798,P=0.028);男性、多灶(≥2 灶)是喉前淋巴结转移的独立危险因素(x2=7.182,P=0.007;x2=5.541,P=0.019).结论 甲状腺微小乳头状癌患者中央区淋巴结转移与性别、年龄、癌灶直径、被膜侵犯密切相关,其中气管旁淋巴结的转移率最高.
Abstract
Objective To explore the related risk factors and clinical application value of lymph node metastasis in the pre laryngeal,pre tracheal,and para tracheal regions of multifocal papillary thyroid microcarcinoma.Method The clincal data and of 629 patients with papillary thyroid microcarcinoma admitted to Peking University Cancer Hospital-Inner Mongolia Hospital from Feb 2023 to Apr 2024 were collected,for the incidence of lymph node metastasis in the central region of the neck,and the relationship between relevant factors and the central lymph node subregions.Result Univariate analysis showed that gender,age,tumor diameter,and whether or not combining Hashimoto's thyroiditis were associated with paratracheal lymph node metastasis;Capsular invasion was associated with pre-tracheal and paratracheal lymph node metastasis,and gender,number was correlated with pre-laryngeal lymph node metastasis(all P＜0.05).The results of multivariate analysis showed that male,age＜55 years,and capsular invasion were independent risk factors for paratracheal lymph node metastasis(x2=8.331,P=0.004;x2=9.139,P=0.003;x2=4.798,P=0.028);Male and multiple lesions(≥2 lesions)are independent risk factors for lymph node metastasis in the larynx(x2=7.182,P=0.007;x2=5.541,P=0.019).Conclusions Central lymph node metastasis in patients with papillary thyroid microcarcinoma is closely related to factors such as gender,age,tumor diameter,and capsular invasion,with the highest metastasis rate observed in the paratracheal lymph nodes.
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