恶性甲状腺肿物和甲状腺乳头状癌Ⅵ区淋巴结转移的危险因素

doi:10.13481/j.1671-587x.20170223

吉林大学学报(医学版) ›› 2017, Vol. 43 ›› Issue (02): 334-338.doi: 10.13481/j.1671-587x.20170223

恶性甲状腺肿物和甲状腺乳头状癌Ⅵ区淋巴结转移的危险因素

赵治艳¹, 盛今东¹, 刘宝国^1,2

1. 北京大学肿瘤医院暨北京市肿瘤防治研究所头颈外科恶性肿瘤发病机制及转化研究教育部重点实验室, 北京 100036;
2. 航天中心医院普外科, 北京 100039

收稿日期:2016-07-06 出版日期:2017-03-28 发布日期:2017-03-31
通讯作者: 刘宝国,主任医师,博士研究生导师(Tel:010-88196622,E-mail:lbg29@163.com) E-mail:lbg29@163.com
作者简介:赵治艳(1989-),女,山东省临沂市人,医师,医学硕士,主要从事甲状腺癌诊治方面的研究。
基金资助:
国家高技术研究发展计划（863计划）项目资助课题（2012AA02A210）

Risk factors of malignant thyroid neoplasms and papillary thyroid cancer level Ⅵ lymph node metastasis

ZHAO Zhiyan¹, SHENG Jindong¹, LIU Baoguo^1,2

1. Department of Head-Neck Surgery, Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Cancer Hospital and Institute, Peking University, Beijing 100036, China;
2. Department of General Surgery, Aerospace Central Hospital, Beijing 100039, China

Received:2016-07-06 Online:2017-03-28 Published:2017-03-31

摘要/Abstract

摘要： 目的：探讨与甲状腺肿物和甲状腺乳头状癌（PTC）Ⅵ区淋巴结转移相关的影响因素，阐明恶性甲状腺肿物和PTC发生Ⅵ区淋巴结转移的危险因素。方法：回顾分析99例行甲状腺癌根治术并行Ⅵ区淋巴结清扫术的PTC患者资料及22例行甲状腺腺叶切除术的结节性甲状腺肿患者资料。依据病理结果将甲状腺乳头状癌病例分为Ⅵ区淋巴结转移组（48例）和未转移组（51例）。利用Pearson χ²检验分析性别、年龄、肿瘤大小、B超显示钙化及边界情况等临床相关因素与恶性甲状腺肿物及PTC患者Ⅵ区淋巴结转移的相关性。结果：性别与甲状腺肿物的良恶性无明显相关性（P=0.959，OR=0.972），但年龄与其有相关性（P<0.05，OR=0.341），B超显示钙化（P< 0.001，OR=0.115）和边界不清（P<0.001，OR=18.947）与甲状腺肿物的良恶性明显相关。性别（P=0.379，OR=1.523）、钙化（P=0.064，OR=2.649）和边界不清（P=0.536，OR=0.727）与PTC患者Ⅵ区淋巴结转移的无相关性，年龄（P<0.01，OR=3.498）和肿瘤大小（P< 0.001，OR=0.177）与其有相关性。B超提示同时存在钙化及边界不清与PTC患者Ⅵ区淋巴结转移无相关性（P=0.189，OR=1.781）。结论：年龄是恶性甲状腺肿物的危险因素，也是PTC患者发生Ⅵ区淋巴结转移的危险因素；B超提示肿物的钙化和边界不清是恶性甲状腺肿物的危险因素，但尚不能作为判断PTC患者Ⅵ区淋巴结转移的临床因素；肿瘤大小可以提示PTC患者是否发生Ⅵ区淋巴结转移。

关键词: 钙化, 甲状腺乳头状癌, 边界, 淋巴结转移

Abstract: Objective: To analyze the influencing factors associated with the malignant thyroid neoplasms and the level Ⅵ lymph node metastasis of papillary thyroid cancer(PTC),and to clarify the risk factors of the malignant thyroid neoplasms and level Ⅵ lymph node metastasis of the patients with PTC. Methods: A retrospective analysis on the materials of 99 PTC patients with routine thyroid nodular thyroid cancer resection and level Ⅵ lymph node dissection and 22 nodular goiter patients with thyroid lobectomy were performed.The PTC patients were divided into lymph node metastasis group (48 cases) and non-lymph node metastasis group (51 cases) based on the pathologic results. The associations between the clinical factors such as gender, age, tumor size, calcification, border and malignant thyroid neoplasms and the level Ⅵ lymph node metastasis of PTC were analyzed using Pearson χ² test. Results: Gender (P=0.959, OR =0.972)had no significant correlation with malignant thyroid neoplasms,but age (P<0.05, OR= 0.341), calcification (P< 0.001, OR = 0.115) and unclear border (P< 0.001, OR = 18.947) were associated with malignant thyroid neoplasms. Gender(P=0.379, OR = 1.523), calcification(P=0.064, OR =2.649) and unclear border(P=0.536, OR =0.727)were not apparently correlated with level Ⅵ lymph node metastasis of PTC, but age (P< 0.01,OR = 3.498) and tumor size (P< 0.001, OR = 0.177) were associated with level Ⅵ lymph node metastasis in the PTC patients. Co-existence of calcification and unclear border(P=0.189, OR=1.781)had no correlation with level Ⅵ lymph node metastasis in the PTC patients. Conclusion: Age is not only a risk factor for malignant thyroid neoplasms, but also a factor associated with level Ⅵ lymph node metastasis in the PTC patients. Calcification and unclear border are also the risk factors for malignant thyroid neoplasms, but they can not determine the central compartment lymph node metastasis in the PTC patients. In addition, tumor size can be prompted to predict the level Ⅵ lymph node metastasis in the PTC patients.

Key words: border, papillary thyroid cancer, lymph node metastasis, calcification

中图分类号:

R736.1

赵治艳, 盛今东, 刘宝国. 恶性甲状腺肿物和甲状腺乳头状癌Ⅵ区淋巴结转移的危险因素[J]. 吉林大学学报(医学版), 2017, 43(02): 334-338.

ZHAO Zhiyan, SHENG Jindong, LIU Baoguo. Risk factors of malignant thyroid neoplasms and papillary thyroid cancer level Ⅵ lymph node metastasis[J]. Journal of Jilin University Medicine Edition, 2017, 43(02): 334-338.

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恶性甲状腺肿物和甲状腺乳头状癌Ⅵ区淋巴结转移的危险因素

Risk factors of malignant thyroid neoplasms and papillary thyroid cancer level Ⅵ lymph node metastasis

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