CAJ | 학술논문

目的分析甲状腺乳头状微小癌(papillary thyroid microcarcinoma,PTMC)的临床病理因素与颈侧区淋巴结转移之间的关系.方法回顾性分析2007年1月至2010年12月本院收治的141例行中央区及颈侧区淋巴结清扫的PTMC患者资料,探讨患者临床病理因素与颈侧区淋巴结转移之间的关系.结果 141例PTMC患者中出现颈侧区淋巴结转移的有56例.单因素及多因素分析均发现肿瘤多发病灶、中央区淋巴结转移、合并桥本甲状腺炎及肿瘤位于甲状腺上极与颈侧区淋巴结转移显著相关(P＜0.05).9例患者(6.4％)出现淋巴结跳跃性转移,单因素分析发现肿瘤位于甲状腺上极与淋巴结跳跃性转移相关.结论对于病理证实的PTMC患者,如出现肿瘤多发病灶、中央区淋巴结转移、合并桥本甲状腺炎及肿瘤位于甲状腺上极则需注意颈侧区淋巴结转移可能.淋巴结跳跃性转移发生少见,当肿瘤位于甲状腺上极时,即使中央区淋巴结未见转移,仍需注意颈侧区淋巴结转移可能.
목적 분석갑상선유두상미소암(papillary thyroid microcarcinoma,PTMC)적림상병리인소여경측구림파결전이지간적관계.방법 회고성분석2007년1월지2010년12월본원수치적141례행중앙구급경측구림파결청소적PTMC환자자료,탐토환자림상병리인소여경측구림파결전이지간적관계.결과 141례PTMC환자중출현경측구림파결전이적유56례.단인소급다인소분석균발현종류다발병조、중앙구림파결전이、합병교본갑상선염급종류위우갑상선상겁여경측구림파결전이현저상관(P＜0.05).9례환자(6.4％)출현림파결도약성전이,단인소분석발현종류위우갑상선상겁여림파결도약성전이상관.결론 대우병리증실적PTMC환자,여출현종류다발병조、중앙구림파결전이、합병교본갑상선염급종류위우갑상선상겁칙수주의경측구림파결전이가능.림파결도약성전이발생소견,당종류위우갑상선상겁시,즉사중앙구림파결미견전이,잉수주의경측구림파결전이가능.
Objective To find the clinical and histopathological predictive factors for lateral lymph node ( LN ) metastasis in thyroid papillary microcarcinoma( PTMC ).Methods From January 2007 to December 2010,141 patients with PTMC underwent central and lateral LN dissections were enrolled in the study.The data from the cases were analyzed retrospectively to determine the predictive factors for lateral LN metastasis.Results Among the aforementioned cases,37 cases ( 26.2％ ) were PTMC with the presence of multifocality,24 ( 16.9％ ) Hashimoto thyroiditis,84 ( 59.6％ ) central LN metastasis,56 ( 39.7％ ) lateral LN metastasis.Multifocality,central LN metastasis,underlying Hashimoto thyroiditis,and upper pole location were significantly related to lateral LN metastasis in univariate analysis( P＜0.05 ).These four factors were also found to be independent predictive factors for lateral LN metastasis in multivariate analysis( P＜0.05 ).9(6.4％ ) of there patients were found to show skip metastasis in which there was lateral LN metastasis but no central LN metastasis.The upper pole location was statistically significantly associated with skip metastasis.Conclusions Patients with multifocality,central LN metastasis,underlying Hashimoto thyroiditis,and upper pole location should be paid more attention to the status of lateral LN.Skip metastasis occurs in a minority of patients with PTMC.Even if there is no central LN metastasis,patients with upper pole lesion should be searched carefully for the lateral cervical LN metastasis.