甲状腺乳头状癌患者甲状腺肿瘤特征对颈侧区淋巴结转移的影响
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福建省宁德师范学院附属宁德市医院

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Effect of thyroid tumor characteristics on lateral lymph node metastasis in papillary thyroid carcinoma
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Department of oncology,Ningde Hospital Affiliated to Ningde Normal University Fu Jian Ning De 352100

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    目的 研究甲状腺乳头状癌患者甲状腺肿瘤特征对颈侧区淋巴结转移的预测作用。方法 回顾分析2017年1月至2020年12月在我院手术治疗的甲状腺乳头状癌患者的病例资料共509例,根据病理诊断结果是否存在颈侧区淋巴结转移,共有178例患者存在颈侧区淋巴结转移,另外331例患者不存在颈侧区淋巴结转移。采用多因素二元Logistic回归分析甲状腺乳头状癌患者颈侧区淋巴结转移的影响因素。结果 比较存在颈侧区转移和不存在颈侧区转移的患者资料发现,存在颈侧区转移的患者中年龄<40岁、肿瘤最大直径>2cm、转移中央区淋巴数量>5个、多灶性以及BRAF不存在突变的患者比例显著高于无转移的患者(P<0.05)。采用多因素二元logistic回顾分析结果发现肿瘤最大直径>2cm(P=0.000,OR=3.482,95%CI:1.482-5.642)、转移中央区淋巴结数量>5个(P=0.000,OR=6.583,95%CI:2.384-12.373)、多灶性(P=0.032,OR=3.473,95%CI:1.387-8.684)以及BRAF不存在突变(P=0.000,OR=3.952,95%CI:1.489-9.572)是甲状腺乳头状癌发生颈侧区淋巴结转移的独立危险因素。结论 肿瘤最大直径>2cm、转移中央区淋巴数量>5个、多灶性以及BRAF不存在突变是甲状腺乳头状癌患者出现颈侧区淋巴结转移的独立危险因素。

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    Objective To investigate the predictive effect of thyroid tumor characteristics on lateral lymph node metastasis in patients with papillary thyroid carcinoma. Methods A total of 509 cases of patients with papillary thyroid carcinoma who underwent surgical treatment in our hospital from January 2017 to December 2020 were retrospectively analyzed. According to the pathological diagnosis, a total of 178 patients had lateral lymph node metastasis, while another 331 patients did not. Multivariate binary Logistic regression was used to analyze the influencing factors of lateral lymph node metastasis in patients with papillary thyroid carcinoma. Results Comparing the data of patients with and without lateral lymph node metastasis, it was found that the proportion of patients with lateral lymph node metastasis who were younger than 40 years old, the largest tumor diameter >2cm, the number of metastatic lymph nodes in the central region >5, multifocality and no BRAF mutation was significantly higher than those without metastasis (P<0.05). The results of multivariate binary logistic retrospective analysis showed that the maximum tumor diameter >2cm (P=0.000, OR=3.482, 95%CI: 1.482-5.642), the number of metastatic lymph nodes in the central region >5 (P=0.000, OR=6.583, 95%CI: 2.384-12.373), multifocality (P=0.032, OR=3.473, 95%CI: 1.387-8.684), and the negative of BRAF mutations (P=0.000, OR=3.952, 95%CI: 1.489-9.572) are independent risk factors for lateral lymph node metastasis from papillary thyroid carcinoma. Conclusion The maximum tumor diameter >2cm, the number of metastatic lymph nodes in the central region >5, multifocality and the negative of BRAF mutation were independent risk factors for cervical lymph node metastasis in patients with papillary thyroid carcinoma.

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  • 收稿日期:2021-06-18
  • 最后修改日期:2021-08-04
  • 录用日期:2021-08-05
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