Vorasubin Nopawan, Nguyen Chau, Wang Marilene
Corresponding author: Nopawan Vorasubin, MD, UC San Diego Medical Center, 200 West Arbor Dr., MD #8895, San Diego, CA 92103. Email:
Ear Nose Throat J. 2016 Feb;95(2):73-7.
A number of studies of predictive factors for lymph node metastasis in papillary thyroid microcarcinoma have been published. We conducted a systematic meta-analysis of some of these studies, and we present our findings herein. We searched the PubMed database and found 13 eligible studies and case series of papillary thyroid microcarcinoma that were published in the English-language literature from January 2001 through December 2012, and we analyzed their findings. The most commonly investigated tumor characteristics associated with lymph node metastasis were size, multifocality, capsular invasion, and lymphovascular invasion. With regard to the risk of developing lymph node metastasis, patients with larger tumors had a 1.93 greater chance (95% confidence interval [CI]: 1.36 to 2.73, p < 0.001), those with multifocal tumors had a 3.03 greater chance (95% CI: 2.05 to 4.47; p < 0.001), those with capsular invasion had a 4.13 greater chance (95% CI: 2.40 to 7.10; p < 0.001), and those with lymphovascular invasion had a 2.76 greater chance (95% CI: 1.50 to 5.07; p = 0.005). We conclude that patients with larger and/or multifocal papillary thyroid microcarcinomas and tumors associated with capsular or lymphovascular invasion have a significantly greater risk of developing lymph node metastasis.
关于甲状腺微小乳头状癌淋巴结转移预测因素的多项研究已发表。我们对其中一些研究进行了系统的荟萃分析，并在此展示我们的研究结果。我们检索了PubMed数据库，发现了13项符合条件的关于甲状腺微小乳头状癌的研究和病例系列，这些研究发表于2001年1月至2012年12月的英文文献中，我们分析了它们的研究结果。与淋巴结转移相关的最常研究的肿瘤特征包括大小、多灶性、包膜侵犯和脉管侵犯。关于发生淋巴结转移的风险，肿瘤较大的患者发生转移的几率高1.93倍（95%置信区间[CI]：1.36至2.73，p<0.001），多灶性肿瘤患者的几率高3.03倍（95%CI：2.05至4.47；p<0.001），有包膜侵犯的患者几率高4.13倍（95%CI：2.40至7.10；p<0.001），有脉管侵犯的患者几率高2.76倍（95%CI：1.50至5.07；p = 0.005）。我们得出结论，甲状腺微小乳头状癌肿瘤较大和/或为多灶性以及伴有包膜或脉管侵犯的患者发生淋巴结转移的风险显著更高。
