甲状腺微小乳头状癌颈部中央区淋巴结转移的临床特征及危险因素分析

doi:10.3760/cma.j.cn441417-20241112-08026

摘要/Abstract

摘要：

目的　分析甲状腺微小乳头状癌（PTMC）颈部中央区淋巴结转移（CLNM）的临床特征及危险因素。方法　回顾性分析，选取2020年1月至2024年6月安康市中心医院收治的237例PTMC患者临床资料，其中男34例、女203例，年龄（45.96±6.05）岁。根据术后病理结果将其分为CLNM组（83例）和非CLNM组（154例）。对比两组患者临床特征，并采用多因素logistic回归模型分析PTMC患者CLNM的危险因素。统计学方法采用t检验、χ²检验、Mann-Whitney U检验。结果　PTMC患者CLNM发生率为35.02%（83/237）。CLNM组年龄及伴发桥本氏甲状腺炎占比均低于非CLNM组［（42.16±5.91）岁比（47.96±6.13）岁、15.66%（13/83）比27.27%（42/154）］，肿瘤内钙化占比、肿瘤侵犯被膜占比、肿瘤多灶性占比、肿瘤最大径、肿瘤纵横比、FT4水平分别为34.94%（29/83）、59.04%（49/83）、39.76%（33/83）、（7.11±1.72）mm、1.15±0.16、（20.98±2.31）pmol/L，均高于非CLNM组的16.23%（25/154）、25.97%（40/154）、19.48%（30/154）、（5.13±1.03）mm、0.94±0.11、（16.67±1.94）pmol/L，差异均有统计学意义（均P<0.05）。年龄、肿瘤最大径、肿瘤纵横比、肿瘤多灶性、肿瘤内钙化、肿瘤侵犯被膜、FT4水平均是PTMC患者CLNM发生的危险因素（均P<0.05）。结论　PTMC并发CLNM者存在年龄小、肿瘤最大径长、纵横比大、多灶、钙化、侵犯被膜、FT4水平高和伴发桥本氏甲状腺炎的特征，其中年龄小、肿瘤最大径长、肿瘤纵横比大、肿瘤内钙化、肿瘤侵犯被膜、肿瘤多灶性、FT4水平高为PTMC并发CLNM的危险因素。

关键词:

甲状腺微小乳头状癌, 中央区淋巴结转移, 临床特征, 危险因素

Abstract:

Objective　To analyze the clinical characteristics and risk factors of cervical lymph node metastasis (CLNM) in papillary thyroid microcarcinoma (PTMC). Methods　The clinical data of 237 patients with PTMC treated at Ankang Central Hospital from January 2020 to June 2024 were retrospectively analyzed. There were 34 males and 203 females who were (45.96±6.05) years old. The patients were divided into a CLNM group (83 cases) and a non-CLNM group (154 cases) according to the postoperative pathological results. The clinical characteristics of the two groups were compared, and the risk factors of CLNM in the patients were analyzed by the multivariate logistic regression model. t and χ² tests were used for the statistical analysis. Results　The incidence rate of CLNM in the patients was 35.02% (83/237). The age and proportion of the patients with Hashimoto's thyroiditis in the CLNM group were lower than those in the non-CLNM group [(42.16±5.91) years vs. (47.96±6.13) years and 15.66% (13/83) vs. 27.27% (42/154)]; the proportions of the patients with calcification in tumors, invasion of tumor capsule, and multi-lesions, maximum tumor diameter, tumor aspect ratio, and level of FT4 in the CLNM group were higher than those in the non-CLNM group [34.94% (29/83) vs. 16.23% (25/154), 59.04% (49/83) vs. 25.97% (40/154), 39.76% (33/83) vs. 19.48% (30/154), (7.11±1.72) mm vs. (5.13±1.03) mm, 1.15±0.16 vs. 0.94±0.11, (20.98±2.31) pmol/L vs. (16.67±1.94) pmol/L]; there were statistical differences (all P<0.05). Age, maximum tumor diameter, tumor aspect ratio, multi-lesions, calcification in tumor, invasion of tumor capsule, and level of FT4 were the risk factors of CLNM in the patients (all P<0.05). Conclusions　Patients with PTMC complicated with CLNM have the characteristics of younger age, bigger maximum tumor diameter and aspect ratio, multi-lesions, calcification, invasion of tumor capsule, higher FT4 level, and Hashimoto's thyroiditis. Among them, younger age, bigger maximum tumor diameter and tumor aspect ratio, calcification in tumor, invasion of tumor capsule, multi-lesions, and high FT4 level are the risk factors for PTMC complicated with CLNM.

Key words:

Thyroid micropapillary carcinoma, Lymph node metastasis in central area, Clinical features, Risk factors

罗振峰赵谦封辉.

甲状腺微小乳头状癌颈部中央区淋巴结转移的临床特征及危险因素分析 [J]. 国际医药卫生导报, 2025, 31(8): 1358-1363.

Luo Zhenfeng, Zhao Qian, Feng Hui.

Clinical characteristics and risk factors of cervical lymph node metastasis in cervical region of papillary thyroid microcarcinoma [J]. International Medicine and Health Guidance News, 2025, 31(8): 1358-1363.

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