Department of General Surgery, Shanghai Ruijin Rehabilitation Hospital, Shanghai, China.
Department of Ultrasound, Shanghai Ruijin Rehabilitation Hospital, Shanghai, China.
BMC Endocr Disord. 2019 Nov 15;19(1):124. doi: 10.1186/s12902-019-0450-8.
To investigate the risk factors of cervical lymph node (LN) metastasis in papillary thyroid microcarcinoma (PTMC) patients.
We retrospectively analyzed the clinicopathologic data of all patients who received standard lobectomy for PTMC at our institution between October 2017 and January 2019. Central LNs were dissected in all patients. Lateral LNs were dissected if metastasis to the lateral LNs was suggested based on pre-op fine-needle aspiration biopsy. The relationship between variables available prior to surgery and cervical LN metastasis was examined using multivariate regression.
Post-op pathologic examination revealed cervical LN metastasis in 79 (29.5%) patients. Seventy subjects had metastasis only to central LNs, and 4 (1.5%) patients had metastasis only to lateral LNs. Five patients had metastasis to both central and lateral LNs. In comparison to patients without cervical LN metastasis, those with LN metastasis were significantly younger (40.63 ± 13.07 vs. 44.52 ± 12.23 years; P = 0.021) and had significantly larger tumor diameter on pathology (6.7 ± 2.2 vs. 5.9 ± 2.4 mm; P = 0.010). Multivariate regression analysis identified the following independent risks for cervical LN metastasis: male sex (OR 2.362, 95%CI 1.2614.425; P = 0.007), age (OR 0.977, 95%CI 0.9560.999; P = 0.042) and ultrasound tumor diameter at > 5 mm (OR 3.172, 95%CI 1.389~7.240; P = 0.006).
Cervical LN metastasis occurs in a non-insignificant proportion of PTMC patients. Independent risks included male sex, younger age and larger tumor diameter on ultrasound.
探讨甲状腺微小乳头状癌（PTMC）患者颈淋巴结（LN）转移的危险因素。
回顾性分析 2017 年 10 月至 2019 年 1 月在我院接受标准甲状腺叶切除术的所有 PTMC 患者的临床病理资料。所有患者均行中央区 LN 清扫术。若术前细针穿刺抽吸活检提示侧颈 LN 转移，则行侧颈 LN 清扫术。采用多因素回归分析术前变量与颈 LN 转移的关系。
术后病理检查发现 79 例（29.5%）患者存在颈 LN 转移。70 例患者仅中央区 LN 转移，4 例（1.5%）患者仅侧颈区 LN 转移，5 例患者中央区和侧颈区均有转移。与无颈 LN 转移的患者相比，有颈 LN 转移的患者明显更年轻（40.63±13.07 岁比 44.52±12.23 岁；P=0.021），且术后病理肿瘤直径明显更大（6.7±2.2 毫米比 5.9±2.4 毫米；P=0.010）。多因素回归分析显示，颈 LN 转移的独立危险因素为：男性（OR 2.362，95%CI 1.2614.425；P=0.007）、年龄（OR 0.977，95%CI 0.9560.999；P=0.042）和超声肿瘤直径>5 毫米（OR 3.172，95%CI 1.389~7.240；P=0.006）。
PTMC 患者颈 LN 转移的发生率并非微不足道。独立危险因素包括男性、年龄较小和超声下肿瘤直径较大。
