Zhang A B, Liu L F, Lu C, Ma Y Y, Dong Y B, Ge X Y
Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical Universtity, Beijing, 100050, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Aug 5;31(15):1141-1145. doi: 10.13201/j.issn.1001-1781.2017.15.001.
To investigate the risk factors of central neck lymph node metastasis (CNLNM) in cN0 papillary thyroid carcinoma. Retrospective analysis of 114 patients with papillary thyroid carcinoma in stage of cN0 who underwent primary treatment. Collected the clinical and pathological data, used the univariate and multivariate analysis to investigate the risk factors of central neck lymph node metastasis and high volume central neck lymph node metastasis.In the univariate analysis, age (48.2% in<45 years vs 27.6% in≥45 years), multifocal (51% with vs 27.7% without), nodular goiter (58.8% with vs 28.7% without), showed significant difference in prevalence of CNLNM. Age (14.3% in<45 years vs 1.7% in≥45 years), tumor size (19.2% >1 cm vs 4.5%≤1 cm) showed significant difference in prevalence of high volume CNLNM. Inmultivariate analysis, age (= 0.304), multifocal (= 3.637) and nodular goiter (= 4.132) showed the independent risk factor of CNLNM.For cN0 patients with thyroid papillary carcinoma, if the age is younger than 45 years old, the tumor is multifocal, or associatedwith nodular goiter, the surgery should be more aggressive in the prophylactic central neck dissection.
探讨cN0期甲状腺乳头状癌中央区颈部淋巴结转移（CNLNM）的危险因素。回顾性分析114例接受初次治疗的cN0期甲状腺乳头状癌患者。收集临床和病理资料，采用单因素和多因素分析探讨中央区颈部淋巴结转移及高容量中央区颈部淋巴结转移的危险因素。单因素分析中，年龄（<45岁者为48.2%，≥45岁者为27.6%）、多灶性（有者为51%，无者为27.7%）、结节性甲状腺肿（有者为58.8%，无者为28.7%）在CNLNM患病率上显示出显著差异。年龄（<45岁者为14.3%，≥45岁者为1.7%）、肿瘤大小（>1 cm者为19.2%，≤1 cm者为4.5%）在高容量CNLNM患病率上显示出显著差异。多因素分析中，年龄（= 0.304）、多灶性（= 3.637）和结节性甲状腺肿（= 4.132）显示为CNLNM的独立危险因素。对于cN0期甲状腺乳头状癌患者，若年龄小于45岁、肿瘤为多灶性或伴有结节性甲状腺肿，在预防性中央区颈部清扫术中手术应更积极。
