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

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.%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.