Zhu Youzhi, Zheng Ke, Zhang Huihao, Chen Ling, Xue Jiajie, Ding Mingji, Wu Kunlin, Wang Zongcai, Kong Lingjun, Chen Xiangjin
Department of Thyroid and Breast Surgery, The First Affiliated Hospital of FuJian Medical University, No. 20, Chazhong Road, ChaTing Street, FuZhou City, FuJian Province, 350000, China.
Department of Pathology, The First Affiliated Hospital of FuJian Medical University, No. 20, Chazhong Road, ChaTing Street, FuZhou City, FuJian Province, 350000, China.
Tumour Biol. 2016 Jun;37(6):8037-45. doi: 10.1007/s13277-015-4706-2. Epub 2015 Dec 28.
This study aims to evaluate the difference of central lymph node metastases (LNM) in papillary thyroid carcinoma (PTC) associated with or without Hashimoto's thyroiditis (HT) in predicting lateral node metastasis. A retrospective case control study was performed. Patients (1276) with PTC who underwent a total or near-total thyroidectomy with at least one lymph node dissection in our institution were retrospectively reviewed. All patients were divided into two groups (HT-group and non-HT group) according to the pathological diagnosis. In HT-group, the incidence of both central and lateral LNM was lower compared with non-HT group. The average of central metastatic lymph node radio (LNR) was also lower than that in Non-HT group. The multivariate analysis showed that the number of metastatic central LNs (HT ≥ 4, Non-HT ≥ 2) and the central LNR (HT ≥ 0.4, Non-HT ≥ 0.6) were independently associated with lateral LNM. Patients with HT need larger primary tumor size, more positive central LN and higher LNR to predict the presence of lateral LNM. HT may protect against central and lateral LNM in PTC. The number of positive central LNs and central LNR in PTC could be used to determine the presence of lateral LNM and inform postoperative follow-up.
本研究旨在评估伴或不伴桥本甲状腺炎（HT）的乳头状甲状腺癌（PTC）中央淋巴结转移（LNM）在预测侧方淋巴结转移方面的差异。进行了一项回顾性病例对照研究。对在我院接受全甲状腺切除或近全甲状腺切除并至少进行一次淋巴结清扫的1276例PTC患者进行回顾性分析。根据病理诊断将所有患者分为两组（HT组和非HT组）。与非HT组相比，HT组中央和侧方LNM的发生率均较低。中央转移淋巴结比值（LNR）的平均值也低于非HT组。多因素分析显示，转移的中央淋巴结数量（HT≥4，非HT≥2）和中央LNR（HT≥0.4，非HT≥0.6）与侧方LNM独立相关。HT患者需要更大的原发肿瘤大小、更多的中央淋巴结阳性和更高的LNR来预测侧方LNM的存在。HT可能对PTC的中央和侧方LNM有保护作用。PTC中中央淋巴结阳性数量和中央LNR可用于确定侧方LNM的存在并指导术后随访。
