中华地方病学杂志
中華地方病學雜誌
중화지방병학잡지
Chinese Journal of Endemiology
2015年
5期
340-343
,共4页
甲状腺%癌,乳头状%淋巴结%淋巴转移
甲狀腺%癌,乳頭狀%淋巴結%淋巴轉移
갑상선%암,유두상%림파결%림파전이
Thyroid gland%Carcinoma,papillary%Lymph nodes%Lymphatic metastasis
目的 分析甲状腺乳头状癌(PTC)患者中央区淋巴结(CLN)转移的相关危险因素,为临床采用手术治疗方式提供依据.方法 通过回顾性调查,分析哈尔滨医科大学附属第三医院甲状腺外科2010年1月至2012年6月初治的407例PTC患者临床病历资料.调查内容包括患者的一般情况,甲状腺特异性抗体,家族病遗传史,病理特征(癌灶直径、癌灶数量、肿瘤部位、浸润被膜),肿瘤TNM分期与CLN转移等.用x2检验进行单因素分析,并用Logistic回归对单因素分析中有统计学意义的指标进行多因素分析.结果 共调查407例PTC患者,CLN转移率为51.351％(209/407).单因素分析显示,PTC患者CLN转移与性别、甲状腺特异性抗体、家族病遗传史、肿瘤部位无明显相关性(x2=1.457、1.106、0.000、0.260,P均＞0.05);与年龄、癌灶数量、癌灶直径、浸润被膜情况、肿瘤TNM分期明显相关(x2=21.080、14.974、47.671、12.858、8.765,P均＜0.01).多因素分析显示,年龄(＜ 45岁)、癌灶直径(≥1.0 cm)、多发癌灶及肿瘤分期(T3+ T4)是CLN转移的危险因素[比值比(OR)=0.937、2.347、0.380、0.389,P均＜0.01].结论 PTC患者年龄(＜45岁)、癌灶直径(≥1.0 cm)、多发癌灶、肿瘤分期(T3+ T4)是CLN转移的危险因素.若相关危险因素存在,应该常规进行CLN清扫.
目的 分析甲狀腺乳頭狀癌(PTC)患者中央區淋巴結(CLN)轉移的相關危險因素,為臨床採用手術治療方式提供依據.方法 通過迴顧性調查,分析哈爾濱醫科大學附屬第三醫院甲狀腺外科2010年1月至2012年6月初治的407例PTC患者臨床病歷資料.調查內容包括患者的一般情況,甲狀腺特異性抗體,傢族病遺傳史,病理特徵(癌竈直徑、癌竈數量、腫瘤部位、浸潤被膜),腫瘤TNM分期與CLN轉移等.用x2檢驗進行單因素分析,併用Logistic迴歸對單因素分析中有統計學意義的指標進行多因素分析.結果 共調查407例PTC患者,CLN轉移率為51.351％(209/407).單因素分析顯示,PTC患者CLN轉移與性彆、甲狀腺特異性抗體、傢族病遺傳史、腫瘤部位無明顯相關性(x2=1.457、1.106、0.000、0.260,P均＞0.05);與年齡、癌竈數量、癌竈直徑、浸潤被膜情況、腫瘤TNM分期明顯相關(x2=21.080、14.974、47.671、12.858、8.765,P均＜0.01).多因素分析顯示,年齡(＜ 45歲)、癌竈直徑(≥1.0 cm)、多髮癌竈及腫瘤分期(T3+ T4)是CLN轉移的危險因素[比值比(OR)=0.937、2.347、0.380、0.389,P均＜0.01].結論 PTC患者年齡(＜45歲)、癌竈直徑(≥1.0 cm)、多髮癌竈、腫瘤分期(T3+ T4)是CLN轉移的危險因素.若相關危險因素存在,應該常規進行CLN清掃.
목적 분석갑상선유두상암(PTC)환자중앙구림파결(CLN)전이적상관위험인소,위림상채용수술치료방식제공의거.방법 통과회고성조사,분석합이빈의과대학부속제삼의원갑상선외과2010년1월지2012년6월초치적407례PTC환자림상병력자료.조사내용포괄환자적일반정황,갑상선특이성항체,가족병유전사,병리특정(암조직경、암조수량、종류부위、침윤피막),종류TNM분기여CLN전이등.용x2검험진행단인소분석,병용Logistic회귀대단인소분석중유통계학의의적지표진행다인소분석.결과 공조사407례PTC환자,CLN전이솔위51.351％(209/407).단인소분석현시,PTC환자CLN전이여성별、갑상선특이성항체、가족병유전사、종류부위무명현상관성(x2=1.457、1.106、0.000、0.260,P균＞0.05);여년령、암조수량、암조직경、침윤피막정황、종류TNM분기명현상관(x2=21.080、14.974、47.671、12.858、8.765,P균＜0.01).다인소분석현시,년령(＜ 45세)、암조직경(≥1.0 cm)、다발암조급종류분기(T3+ T4)시CLN전이적위험인소[비치비(OR)=0.937、2.347、0.380、0.389,P균＜0.01].결론 PTC환자년령(＜45세)、암조직경(≥1.0 cm)、다발암조、종류분기(T3+ T4)시CLN전이적위험인소.약상관위험인소존재,응해상규진행CLN청소.
Objective To study the risk factors of central lymph node (CLN) metastasis in papillary thyroid carcinoma (PTC),to provide the basis for clinical treatment.Methods A total of 407 patients with PTC in thyroid surgery,the Third Affiliated Hospital of Harbin Medical University from January 2010 to June 2012 who had undergone at least ipsilateral CLN were studied.These factors included normal situation,thyroidglobulin antibody or thyroid microsomal antibody,family history,pathological features (the size of primary,tumor multifocal,tumor location and capsular invasion),TNM staging and CLN metastasis.Univariate analysis and multivariate analysis were performed using x2 test and binary Logistic regression test,respectively.Results The CLN metastasis rate was 51.351％ (209/407) of the 407 patients with PTC.The CLN metastasis was significantly associated with age,tumor multifocal,the size of primary tumor,capsular invasion and TNM (x2 =21.080,14.974,47.671,12.858,8.765,all P ＜ 0.01).Sex,thyroid globulin antibody or thyroid microsomal antibody,family history and tumor location were not associated with CLN metastasis (x2 =1.457,1.106,0.000,0.260,all P ＞ 0.05).Multivariate analysis indicated that age (＜ 45 year),the size of primary tumor (≥ 1.0 cm),tumor-muhifocal,and TNM (T3 + T4) were the independent risk factors for CLN metastasis [odds ratio (OR) =0.937,2.347,0.380,0.389,all P ＜ 0.01].Conclusions Age (＜ 45 year),the size of primary tumor (≥ 1.0 cm),tumor-multifocal and TNM (T3 + T4) are risk factors for CLN metastasis in PTC.Dissection of CLN should be considered for PTC patients with these factors.
