甲状腺乳头状癌颈部淋巴结转移规律及影响因素

摘要

目的：探讨甲状腺乳头状癌颈部淋巴结转移规律及影响因素。方法选取甲状腺乳头状癌患者154例，根据有无中央区及侧颈区淋巴结转移，采用单因素分析结合多因素分析的方法研究患者颈部淋巴结转移规律和影响因素。结果单因素分析发现，男性、年龄<45岁、肿瘤直径﹥1.0 cm、多发灶、侵袭外膜、不伴结节性甲状腺肿、不伴甲状腺瘤、超声显示淋巴结转移的患者中央区淋巴结转移率较高（ P <0.05）；男性、年龄<45岁、肿瘤直径﹥1.0 cm、侵袭外膜、超声显示淋巴结转移是患者颈部中央区淋巴结转移的危险因素（ P <0.05）。单因素分析发现，男性、年龄<45岁、肿瘤直径﹥1.0 cm、多发灶、侵袭外膜、超声显示淋巴结转移、中央区淋巴结转移的患者侧颈区淋巴结转移率较高（ P <0.05）；多因素分析发现，侵袭外膜、超声显示淋巴结转移、中央区淋巴结转移是患者颈部侧颈区淋巴结转移的危险因素（ P <0.05）。结论男性、年龄<45岁、肿瘤直径﹥1.0 cm、侵袭外膜、超声显示淋巴结转移是甲状腺乳头状癌患者中央区淋巴结转移的危险因素，而侵袭外膜、超声显示淋巴结转移、中央区淋巴结转移是患者侧颈区淋巴结转移的危险因素。%Objective To explore the metastatic pattern and influencing factors of cervical lymph node in papillary thyroid carcinoma. Methods 154 patients with papillary thyroid carcinoma were selected into this study. All the influencing factors of cervical lymph node were ana-lysed by single factor analysis and multiple factor analysis according to central cervical lymph node and lateral cervical lymph node metastasis. Re-sults Single factor analysis showed that patients of man,less than 45 years old,tumor diameter more than 1. 0 cm,multiple foci,invasion of the outer membrane,without nodular goiter,without thyroid tumor,ultrasonography showed lymph node metastasis had higher rate of central cervical lymph node metastasis( P < 0. 05). Multiple factor analysis showed that man,less than 45 years old,tumor diameter more than 1. 0 cm,invasion of the outer membrane,ultrasonography showed lymph node metastasis were risk factors for central cervical lymph node metastasis( P < 0. 05). Single factor analysis showed that patients of man,less than 45 years old,tumor diameter more than 1. 0 cm,multiple foci,invasion of the outer membrane,ultrasonography showed lymph node metastasis,central cervical lymph node metastasis had higher rate of lateral cervical lymph node metastasis( P < 0. 05). Multiple factor analysis showed that invasion of the outer membrane,ultrasonography showed lymph node metastasis, central cervical lymph node metastasis were risk factors for lateral cervical lymph node metastasis( P < 0. 05). Conclusion Man,less than 45 years old,tumor diameter more than 1. 0 cm,invasion of the outer membrane,ultrasonography showed lymph node metastasis were risk factors for central cervical lymph node metastasis while invasion of the outer membrane,ultrasonography showed lymph node metastasis,central cervical lymph node metastasis were risk factors for lateral cervical lymph node metastasis.