国际外科学杂志
國際外科學雜誌
국제외과학잡지
INTERNATIONAL JOURNAL OF SURGERY
2013年
5期
306-310
,共5页
甲状腺%癌,乳头状%多发病灶%构成比%诊断%淋巴结转移%治疗
甲狀腺%癌,乳頭狀%多髮病竈%構成比%診斷%淋巴結轉移%治療
갑상선%암,유두상%다발병조%구성비%진단%림파결전이%치료
Thyroid gland%Carcinoma,papillary%Multifocal%Constituentratio%Diagnosis%Lymph node metastasis%Treatment
目的 探讨甲状腺乳头状癌中多灶性甲状腺乳头状癌的构成比变化、淋巴结转移及预后等临床特点.方法 回顾性分析大连医科大学附属第一医院2002年1月-2011年12月首次诊断并接受手术治疗且术后病理证实为甲状腺乳头状癌的病例1616例,分析多灶性甲状腺乳头状癌占甲状腺乳头状癌的构成比变化；比较多灶性甲状腺乳头状癌组(A组)与单灶组(B组)及多灶性甲状腺乳头状癌组内不同亚组相关临床特点的差异.结果 多灶性甲状腺乳头状癌占甲状腺乳头状癌的构成比由2002年的8.33％(4/48)逐渐上升至2011年的30.38％(96/316).A组与B组相比有更高的颈部淋巴结转移率(45.09％ vs25.02％;P =0.000)和腺体外浸润率(20.95％vs 9.04％;P =0.000).多灶性甲状腺乳头状癌组中非单纯微小癌组比单纯微小癌组、病灶数目≥3个的病灶组比病灶数目为2个的病灶组发生颈部淋巴结转移的概率高(P＜0.001),而腺体外浸润发病率则差异均无统计学意义(P＞0.05).术后病理证实在多灶性甲状腺乳头状癌中有颈部淋巴结转移的患者比无淋巴结转移的患者复具有更高的复发率(24.05％ vs 8.98％;P=0.000).结论 多灶性甲状腺乳头状癌的患者数量及构成比呈逐年上升趋势；多灶性甲状腺乳头状癌组较单灶组易发生颈部淋巴结转移及腺体外浸润；非单纯微小癌组比单纯微小癌组、病灶数目≥3个的病灶组比病灶数目为2个的病灶组发生颈部淋巴结转移的概率高,而腺体外浸润发病率则无差别；颈部淋巴结转移与疾病的复发呈正相关.
目的 探討甲狀腺乳頭狀癌中多竈性甲狀腺乳頭狀癌的構成比變化、淋巴結轉移及預後等臨床特點.方法 迴顧性分析大連醫科大學附屬第一醫院2002年1月-2011年12月首次診斷併接受手術治療且術後病理證實為甲狀腺乳頭狀癌的病例1616例,分析多竈性甲狀腺乳頭狀癌佔甲狀腺乳頭狀癌的構成比變化；比較多竈性甲狀腺乳頭狀癌組(A組)與單竈組(B組)及多竈性甲狀腺乳頭狀癌組內不同亞組相關臨床特點的差異.結果 多竈性甲狀腺乳頭狀癌佔甲狀腺乳頭狀癌的構成比由2002年的8.33％(4/48)逐漸上升至2011年的30.38％(96/316).A組與B組相比有更高的頸部淋巴結轉移率(45.09％ vs25.02％;P =0.000)和腺體外浸潤率(20.95％vs 9.04％;P =0.000).多竈性甲狀腺乳頭狀癌組中非單純微小癌組比單純微小癌組、病竈數目≥3箇的病竈組比病竈數目為2箇的病竈組髮生頸部淋巴結轉移的概率高(P＜0.001),而腺體外浸潤髮病率則差異均無統計學意義(P＞0.05).術後病理證實在多竈性甲狀腺乳頭狀癌中有頸部淋巴結轉移的患者比無淋巴結轉移的患者複具有更高的複髮率(24.05％ vs 8.98％;P=0.000).結論 多竈性甲狀腺乳頭狀癌的患者數量及構成比呈逐年上升趨勢；多竈性甲狀腺乳頭狀癌組較單竈組易髮生頸部淋巴結轉移及腺體外浸潤；非單純微小癌組比單純微小癌組、病竈數目≥3箇的病竈組比病竈數目為2箇的病竈組髮生頸部淋巴結轉移的概率高,而腺體外浸潤髮病率則無差彆；頸部淋巴結轉移與疾病的複髮呈正相關.
목적 탐토갑상선유두상암중다조성갑상선유두상암적구성비변화、림파결전이급예후등림상특점.방법 회고성분석대련의과대학부속제일의원2002년1월-2011년12월수차진단병접수수술치료차술후병리증실위갑상선유두상암적병례1616례,분석다조성갑상선유두상암점갑상선유두상암적구성비변화；비교다조성갑상선유두상암조(A조)여단조조(B조)급다조성갑상선유두상암조내불동아조상관림상특점적차이.결과 다조성갑상선유두상암점갑상선유두상암적구성비유2002년적8.33％(4/48)축점상승지2011년적30.38％(96/316).A조여B조상비유경고적경부림파결전이솔(45.09％ vs25.02％;P =0.000)화선체외침윤솔(20.95％vs 9.04％;P =0.000).다조성갑상선유두상암조중비단순미소암조비단순미소암조、병조수목≥3개적병조조비병조수목위2개적병조조발생경부림파결전이적개솔고(P＜0.001),이선체외침윤발병솔칙차이균무통계학의의(P＞0.05).술후병리증실재다조성갑상선유두상암중유경부림파결전이적환자비무림파결전이적환자복구유경고적복발솔(24.05％ vs 8.98％;P=0.000).결론 다조성갑상선유두상암적환자수량급구성비정축년상승추세；다조성갑상선유두상암조교단조조역발생경부림파결전이급선체외침윤；비단순미소암조비단순미소암조、병조수목≥3개적병조조비병조수목위2개적병조조발생경부림파결전이적개솔고,이선체외침윤발병솔칙무차별；경부림파결전이여질병적복발정정상관.
Objective To explore the constituent ratio and clinical characteristics of multifocal thyroid papillary carcinoma (MPTC).Methods The clinical data of 1616 cases of papillary thyroid carcinoma(PTC) were retrospectively analyzed from January 2002 to December 2011 of the First Affiliate Hospital of Dalian Medical University,which operated at the first time and confirmed by pathology.The change of constituent ratio of MPTC in PTC was analyzed and the differences of the clinical characteristics of the multifocal group and single focal group were analyzed.Results The constituent ratio of MPTC in PTC was increasing from 8.33％ (4/48) in 2002 to 30.38％ (96/316) in 2011 gradually.Compared to the single focal group,MPTC group had higher rate of neck lymph node metastasis(45.09％ vs 25.02％ ; P =0.000) and extrathyroidal invasion (20.95％ vs 9.04％ ;P =0.000).Compared with pure microcarcinoma,none pure microcarcinoma had higher rate of neck lymph node metastasis (P =0.000).More than two focuses has higher rate of neck lymph node metastasis than two focuses (P =0.000).The rate of recurrence with lymph node metastasis was higher than that without lymph node metastasis (24.05％ vs 8.98％ ;P =0.000) conformed by postoperative pathology.Conclusions The number and constituent ratio of MPTC in PTC is increasing gradually.MPTC group has high proportion of lymph node metastasis and extrathyroidal invasion than single focal group.None pure microcarcinoma has higher rate of neck lymph node metastasis than pure microcarcinoma;more than two focuses has higher rate of neck lymph node metastasis than two focuses.The recurrence rate is correlated with the rate of lymph node metastasis.
