Sui C, He Q, Du R, Zhang D, Li F, Dionigi G, Liang N, Sun H
Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun City, China.
Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood 'G. Barresi', University Hospital 'G. Martino', The University of Messina, Messina, Italy.
Endocr Connect. 2020 Mar;9(3):201-210. doi: 10.1530/EC-20-0019.
This study examined the clinicopathological characteristics of 6279 N1 differentiated thyroid cancer (DTC) patients who underwent operations in our center.
This was a retrospective longitudinal analysis. We categorized the DTC patients on the basis of various lymph node (LN) characteristics. Logistic regression models and multiple linear regression models were used for the correlation analysis.
A total of 3693 (58.8%) N1a patients and 2586 (41.2%) N1b patients were included. Patients with N1b disease had larger metastatic foci (0.5 vs 0.15 cm), a greater number of metastatic LNs (5 vs 2), a greater number of dissected LNs (25 vs 7), and a smaller lymph node ratio (NR, number of positive LNs/number of sampled LNs) (23.1% vs 28.6%) than patients in stage N1a. Comparing the clinicopathological features, we found that male, increased tumor size, multifocality, and thyroiditis increased the risk of stage N1b disease (P < 0.05). Sex, multifocality, capsular infiltration, and tumor size were associated with the size of the metastatic LNs (P < 0.05). Sex, capsular infiltration, and nodular goiter were associated with the NR (P < 0.05). Female sex, tumor located in inferior lobe, maximal tumor diameter (MTD) < 1 cm, and nodular goiter were independent predictors for skip metastases (P < 0.05). MTD > 1 cm, central neck metastasis and age were independent predictors for bilateral lateral neck metastasis (BLNM) (P < 0.05).
The LN characteristics of stage N1a and N1b disease were associated with significantly different features, such as sex, tumor size, multifocality, capsular infiltration, and nodular goiter.
本研究探讨了在我院中心接受手术的6279例N1期分化型甲状腺癌（DTC）患者的临床病理特征。
这是一项回顾性纵向分析。我们根据各种淋巴结（LN）特征对DTC患者进行分类。采用逻辑回归模型和多元线性回归模型进行相关性分析。
共纳入3693例（58.8%）N1a期患者和2586例（41.2%）N1b期患者。与N1a期患者相比，N1b期患者的转移灶更大（0.5 vs 0.15 cm）、转移淋巴结数量更多（5 vs 2）、清扫淋巴结数量更多（25 vs 7）、淋巴结转移率（NR，阳性淋巴结数量/采样淋巴结数量）更低（23.1% vs 28.6%）。比较临床病理特征，我们发现男性、肿瘤大小增加、多灶性和甲状腺炎会增加N1b期疾病的风险（P < 0.05）。性别、多灶性、包膜浸润和肿瘤大小与转移淋巴结的大小相关（P < 0.05）。性别、包膜浸润和结节性甲状腺肿与NR相关（P < 0.05）。女性、肿瘤位于下叶、最大肿瘤直径（MTD）< 1 cm和结节性甲状腺肿是跳跃转移的独立预测因素（P < 0.05）。MTD > 1 cm、中央区颈部转移和年龄是双侧侧颈部转移（BLNM）的独立预测因素（P < 0.05）。
N1a期和N1b期疾病的LN特征与显著不同的特征相关，如性别、肿瘤大小、多灶性、包膜浸润和结节性甲状腺肿。
