Eskisehir Osmangazi University Medical Faculty Departments of Endocrinology, Turkey.
Eskisehir Osmangazi University Medical Faculty Departments of Endocrinology, Turkey.
J Natl Med Assoc. 2018 Aug;110(4):384-390. doi: 10.1016/j.jnma.2017.07.007. Epub 2017 Aug 7.
Papillary thyroid cancer (PTC) constitutes more than 90% of newly emerging differentiated thyroid cancers. Lymph node metastasis is often seen in PTC. There is a high risk of central metastasis in the presence of clinicopathological factors such as extrathyroidal extension, multifocality and lymphovascular invasion. The aim of this study is to evaluate the clinicopathological features that are effective in the development of lymph node metastasis.
A retrospective examination was made of the records of patients diagnosed with papillary thyroid cancer and followed up in our clinic. Patients with and without lymph node metastasis were compared in respect of demographic features such as age, gender, pathology, histopathology, tumor size, lymph node metastasis, lymphovascular invasion, multifocality, capsule invasion, extrathyroidal extension and bilaterality.
Lymph node metastasis was determined in 52 of 419 papillary thyroid cancers. In the logistic regression analysis, a statistically significant relationship was determined between cervical lymph node metastasis and age <45 years (p < 0.001, OR:4.193), lymphovascular invasion (p < 0.001, OR:7.762), capsule invasion (p < 0.002, OR:3.054), extrathyroidal extension (p < 0.001, OR:6.450) and bilaterality (p < 0.001, OR: 0.217).
The risk of cervical lymph node metastasis was determined to be high in the presence of clinicopathological factors such as extrathyroidal extension, multifocality and lymphovascular invasion. Although lymph node metastasis does not clinically develop in all patients, knowing the risk factors related to lymph node metastasis can contribute to the evaluation of prophylactic central neck dissection in high-risk patients and follow-up of the patient in respect of recurrence.
甲状腺乳头状癌（PTC）构成了超过 90%的新出现的分化型甲状腺癌。PTC 常发生淋巴结转移。在外生型、多灶性和血管淋巴管侵犯等临床病理因素存在的情况下，中央转移的风险较高。本研究旨在评估有助于淋巴结转移发生的临床病理特征。
对在我们诊所诊断为甲状腺乳头状癌并接受随访的患者的记录进行回顾性检查。比较了有和无淋巴结转移的患者在年龄、性别、病理学、组织病理学、肿瘤大小、淋巴结转移、血管淋巴管侵犯、多灶性、包膜侵犯、外生型和双侧性等方面的特征。
在 419 例甲状腺乳头状癌中，有 52 例发生了淋巴结转移。在逻辑回归分析中，颈淋巴结转移与年龄<45 岁（p<0.001，OR：4.193）、血管淋巴管侵犯（p<0.001，OR：7.762）、包膜侵犯（p<0.002，OR：3.054）、外生型（p<0.001，OR：6.450）和双侧性（p<0.001，OR：0.217）之间存在统计学显著关系。
在外生型、多灶性和血管淋巴管侵犯等临床病理因素存在的情况下，颈淋巴结转移的风险较高。虽然并非所有患者均会出现临床淋巴结转移，但了解与淋巴结转移相关的危险因素有助于评估高危患者预防性中央颈清扫术的必要性，并对患者的复发情况进行随访。
