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儿童甲状腺癌:cN0 乳头状癌患者中央淋巴结转移的危险因素

Pediatric thyroid cancer: Risk factors for central lymph node metastasis in patients with cN0 papillary carcinoma.

作者信息

Ngo Duy Quoc, Ngo Quy Xuan, Van Le Quang

机构信息

Department of Head and Neck Surgery, Vietnam National Cancer Hospital, 30 Cau Buou Street, Thanh Tri District, Hanoi, Viet Nam.

Department of Head and Neck Surgery, Vietnam National Cancer Hospital, 30 Cau Buou Street, Thanh Tri District, Hanoi, Viet Nam; Hanoi Medical University, 1 Ton That Tung Street, Hanoi, Viet Nam.

出版信息

Int J Pediatr Otorhinolaryngol. 2020 Jun;133:110000. doi: 10.1016/j.ijporl.2020.110000. Epub 2020 Mar 12.

Abstract

INTRODUCTION

Prophylactic central neck node dissection (CND) for pediatric patients with papillary thyroid cancer (PTC) is still controversial. We aimed to identify the incidence and the predictive parameters of the central lymph node metastasis (CLN) in pediatric patients with cN0 PTC.

METHODS

This retrospective study had included 32 pediatric patients with cN0 PTC who underwent total thyroidectomy and prophylactic CND from 2015 to 2019.

RESULTS

The proportion of CLN metastasis was 75.0%. Univariate logistic regression demonstrated that CLN metastasis was associated with age (≤15 years; p = 0.028), tumour size > 1 cm (p = 0.008), multifocality (p = 0.028) and external extension (p = 0.041) Multivariate logistic regression revealed that age (≤15 years), multifocality, tumour size (>1 cm) and external extension were independent risk factors of CLN metastasis in pediatric patients.

CONCLUSIONS

In summary, central lymph node metastasis occurred in 75% of cN0 pediatric patient and were more common in larger tumour size (>1 cm), multifocal tumours, extrathyroidal extension, and younger age.

摘要

引言

对于患有乳头状甲状腺癌(PTC)的儿科患者,预防性中央颈部淋巴结清扫术(CND)仍存在争议。我们旨在确定cN0期PTC儿科患者中央淋巴结转移(CLN)的发生率和预测参数。

方法

这项回顾性研究纳入了2015年至2019年间32例接受全甲状腺切除术和预防性CND的cN0期PTC儿科患者。

结果

CLN转移比例为75.0%。单因素逻辑回归显示,CLN转移与年龄(≤15岁;p = 0.028)、肿瘤大小>1 cm(p = 0.008)、多灶性(p = 0.028)和甲状腺外侵犯(p = 0.041)相关。多因素逻辑回归显示,年龄(≤15岁)、多灶性、肿瘤大小(>1 cm)和甲状腺外侵犯是儿科患者CLN转移的独立危险因素。

结论

总之,75%的cN0期儿科患者发生中央淋巴结转移,且在肿瘤较大(>1 cm)、多灶性肿瘤、甲状腺外侵犯和年龄较小的患者中更常见。

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