| Guangcai Niu,Hao Guo. Risk factors for lymph node metastasis of cN0 papillary thyroid carcinoma. Oncol Transl Med, 2022, 8: 89-93. |
| cN0期甲状腺乳头状癌患者颈淋巴结转移危险因素分析 |
| Risk factors for lymph node metastasis of cN0 papillary thyroid carcinoma |
| Received:November 22, 2021 Revised:April 25, 2022 |
| DOI：10.1007/s10330-021-0538-8 |
| 中文关键词: 甲状腺乳头状癌；危险因素；并发症 |
| 英文关键词: papillary thyroid carcinoma; risk factor; complication |
| 基金项目: |
| Author Name | Affiliation | E-mail | | Guangcai Niu | Department of Oncological Surgery, Xuzhou Central Hospital | n10046@163.com | | Hao Guo* | Department of Oncological Surgery, Xuzhou Central Hospital | m10046@126.com |
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| 中文摘要: |
| 目的：探讨临床分期淋巴结阴性(cN0)的甲状腺乳头状癌(PTC)患者颈部淋巴结转移的危险因素。
病人和方法：回顾性分析2018年1月至2020年12月徐州中心医院cN0期甲状腺癌手术患者，手术方式至少接受了一侧腺叶切除+中央淋巴结清扫术。用单因素和多因素分析来检测颈淋巴结转移的危险因素。
结果：本研究共有312名cN0期甲状腺乳头状癌患者参加，结果显示134例(42.9%)出现中央区淋巴结转移(CLNM)，其中24例(17.9%)出现颈侧区淋巴结转移(LLNM)。单因素分析表明：男性，年龄<45岁，肿瘤直径≥10毫米，双侧病灶，包膜侵犯和多处癌灶与颈部淋巴结转移有关 (P < 0.05)。多因素分析结果表明，这些因素中除了年龄都是颈部淋巴结转移的独立危险因素 (P < 0.05)。结果还发现随着 CLNM阳性数目增加 LLNM的风险也在增加(P < 0.05)。
结论：cN0期甲状腺乳头状癌颈部淋巴结转移与很多因素有关,随着CLNM转移增加LLNM风险随之增加。对于具有这些危险因素的患者, 应在第一次手术中预防性行中央区淋巴结清扫，并且对于中央淋巴结转移较多的患者我们应该谨慎地行颈外侧淋巴结清扫。 |
| 英文摘要: |
| Objective To investigate the risk factors for cervical lymph node metastasis of clinically lymph nodenegative (cN0) papillary thyroid carcinoma (PTC).
Methods Patients and Methods: The clinicopathologic data of patients with cN0 PTC who underwent at
least one lobectomy plus central lymph node dissection at Xuzhou Central Hospital from January 2018 to
December 2020 were retrospectively collected and the risk factors of lymph node metastasis analyzed.
Univariate and multivariate analyses were performed to detect the risk factors for cervical lymph node
metastasis.
Results A total of 312 patients with cN0 PTC were enrolled in this study. The postoperative pathology
results showed that 134 patients (42.9%) had central lymph node metastasis, of whom 24 (17.9%) had
lateral lymph node metastasis (LLNM). The univariate analysis results showed that male gender, age <45
years, tumor diameter ≥10 mm, bilateral cancer, capsule invasion, and multiple foci were associated with
cervical lymph node metastasis of cN0 PTC (P < 0.05). Further logistic regression analysis results showed
that these factors, except age, were independent risk factors for cervical lymph node metastasis of cN0
PTC (P < 0.05). The results also showed that the risk of LLNM increased with an increase in the number of
positive central lymph nodes in patients with cN0 PTC (P < 0.05).
Conclusion Cervical lymph node metastasis of cN0 PTC is related to many factors, and a high number
of positive central lymph nodes indicates a high risk of LLNM. Patients with risk factors should undergo
preventive central lymph node dissection at the first surgery, and in patients with a high number of positive
central lymph nodes, lateral lymph node dissection should be discreetly performed. |
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