中央淋巴结的淋巴结状态是甲状腺乳头状癌的一个负预后因素。

Nodal status of central lymph nodes as a negative prognostic factor for papillary thyroid carcinoma.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.

出版信息

J Surg Oncol. 2013 Jun;107(7):777-82. doi: 10.1002/jso.23308. Epub 2013 May 2.

DOI:10.1002/jso.23308

PMID:23640873

Abstract

BACKGROUND

The status of metastatic lymph nodes, including the size and extracapsular spread (ECS), in papillary thyroid cancer (PTC) has not been well established. This study evaluated the correlation between the specific status of central lymph node metastases (CLNM) and negative prognostic factors.

METHODS

We reviewed 243 patients who underwent total thyroidectomy and neck dissection. The CLNM slides were reviewed and the relationship between the CLNM status and risk factors was analyzed.

RESULTS

CLNM were found in 111 patients. ECS (+) was related to a large tumor, high number of CLNM, and large node (P < 0.05). Tumor size and number of CLNM were related to the ECS rate (OR = 3.861 and 2.491, respectively; P < 0.01) in a multivariate analysis. Large nodes (≥ 6 mm) were related to large tumor size, extrathyroidal extension, number of CLNM, and lateral cervical lymph node metastasis (LNM). Tumor size and LNM (OR = 4.519 and 7.811, respectively; P < 0.05) were related to large nodes in a multivariate analysis.

CONCLUSIONS

ECS was related to node size, tumor size, and number of CLNM. Node size was related to tumor size and LNM. Thus, specific nodal status is a possible prognostic factor for PTC.

摘要

背景

甲状腺乳头状癌（PTC）的转移性淋巴结状况，包括大小和包膜外扩散（ECS），尚未得到充分确定。本研究评估了中央淋巴结转移（CLNM）的特定状态与阴性预后因素之间的相关性。

方法

我们回顾了 243 例接受甲状腺全切除术和颈部淋巴结清扫术的患者。对 CLNM 切片进行了回顾，并分析了 CLNM 状态与危险因素之间的关系。

结果

在 111 例患者中发现 CLNM。ECS（+）与肿瘤较大、CLNM 数量较多和淋巴结较大有关（P<0.05）。在多变量分析中，肿瘤大小和 CLNM 数量与 ECS 发生率相关（OR=3.861 和 2.491，分别；P<0.01）。大淋巴结（≥6mm）与肿瘤大、甲状腺外延伸、CLNM 数量和颈侧淋巴结转移（LNM）有关。肿瘤大小和 LNM（OR=4.519 和 7.811，分别；P<0.05）与多变量分析中的大淋巴结相关。