Zhang S, Jiang X H
Department of Head and Neck Surgery, Hubei Cancer Hospital, Wuhan, 430079, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Sep;32(17):1319-1324. doi: 10.13201/j.issn.1001-1781.2018.17.007.
To explore the clinical features of papillary thyroid carcinoma(PTC) patients associated with lateral lymph node metastasis(LLNM) in different ages. One hundred and sixtyfive PTC patients associated with LLNM were included in the study and divided into three groups(22-＜30y,30-＜45y and 45-65y). The gender, the number and the ratio of neck lymph node metastasis, maximum tumor diameter, multifocality, preoperative serum thyroid stimulating hormone(TSH), the capsular invasion, extrathyroidal extension and other clinical features in different ages were analyzed.The median age of the patients was 39 years. There were no significant differences in the maximum tumor diameter ＞1cm,multifocality and preoperative serum TSH level among the three groups. The proportion of female patients in 22-＜30y group was higher than the other two groups(all <0.05).The rate of bilateral lesions in 45-65y group was higher than 22-＜30y group (<0.01).The rates of the capsular invasion and extrathyroidal extension in 22-＜30y group and 30-45 group were similarly lower than 30-＜45y group(<0.05).The proportion of the 22-＜30y group coexistent with Hashimoto thyroiditis was higher than the other two groups(<0.05). When the number of central lymph node metastasis(CLNM)＞3,the proportion of 22-＜30y group were higher than the other two groups(all <0.01), the 30-＜45y group was the same as higher than 45-65y group(<0.05); When the ratio of CLNM＞0.35,the proportion of 30-＜45y group was significantly higher than the other two groups(all <0.05).When the number of LLNM＞6, 22-＜30y group was significantly higher than the other two groups;when the ratio of LLNM＞0.33, 45-65y group was lower than the other two groups(all <0.05).The total lymph node metastasis＞11, the proportion of 22-＜30y group was significantly higher than the other two groups(all <0.05), meanwhile 30-＜45y was higher than 45-65y group(<0.05);when the ratio of total lymph node metastasis＞0.22,45-65y group was significantly higher than the other two groups(all <0.01). There is a high proportion of female and maximum tumor diameter over 1cm in PTC associated with LLNM. The proportion of coexistent with Hashimoto thyroiditis and the number of lymph node metastasis are much higher in 22-＜30y group. The higher ratio of CLNM is much more common in 30-＜45y group. The bilateral lesions are more likely to occur in 45-65y group, and meanwhile the tumor is more easier to invade the capsular and extrathyroidal construction. The number and the ratio of total lymph node metastasis might be lower in PTC associated with LLNM of older patients.
探讨不同年龄段甲状腺乳头状癌（PTC）患者伴侧方淋巴结转移（LLNM）的临床特征。本研究纳入165例伴LLNM的PTC患者，分为三组（22～＜30岁、30～＜45岁和45～65岁）。分析不同年龄组患者的性别、颈部淋巴结转移数量及比例、最大肿瘤直径、多灶性、术前血清促甲状腺激素（TSH）、包膜侵犯、甲状腺外侵犯等临床特征。患者中位年龄为39岁。三组间最大肿瘤直径＞1cm、多灶性及术前血清TSH水平差异无统计学意义。22～＜30岁组女性患者比例高于其他两组（均＜0.05）。45～65岁组双侧病变发生率高于22～＜30岁组（＜0.01）。22～＜30岁组和30～45岁组包膜侵犯及甲状腺外侵犯发生率均低于30～＜45岁组（＜0.05）。22～＜30岁组合并桥本甲状腺炎的比例高于其他两组（＜0.05）。当中央区淋巴结转移（CLNM）数量＞3时，22～＜30岁组比例高于其他两组（均＜0.01），30～＜45岁组高于45～65岁组（＜0.05）；当CLNM比例＞0.35时，30～＜45岁组比例显著高于其他两组（均＜0.05）。当LLNM数量＞6时，22～＜30岁组显著高于其他两组；当LLNM比例＞0.33时，45～65岁组低于其他两组（均＜0.05）。总淋巴结转移＞11时，22～＜30岁组比例显著高于其他两组（均＜0.05），同时30～＜45岁组高于45～65岁组（＜0.05）；当总淋巴结转移比例＞0.22时，45～65岁组显著高于其他两组（均＜0.01）。伴LLNM的PTC患者中女性比例及最大肿瘤直径＞1cm者比例较高。22～＜30岁组合并桥本甲状腺炎及淋巴结转移数量比例更高。CLNM比例较高在30～＜45岁组更为常见。双侧病变在45～65岁组更易发生，同时肿瘤更易侵犯包膜及甲状腺外结构。老年患者伴LLNM的PTC患者总淋巴结转移数量及比例可能更低。
