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目的探索c N0期乳头状甲状腺癌(PTC)中央区淋巴结转移(CLNM)的危险因素。方法回顾性分析2014年3~7月期间广东省人民医院收治的行预防性中央区淋巴结清扫(p CND)的94例c N0期PTC患者的临床病理资料。结果术后经病理学检查证实,94例患者发生CLNM 43例(45.7%)。多因素分析结果表明,年龄<45岁、B超示病灶靠近前方、肿瘤直径>2 cm、包膜外侵及p CND清扫淋巴结数>3枚患者的CLNM发生率较高(P<0.05)。结论年龄<45岁、B超示病灶靠近前方及肿瘤直径>2 cm均是c N0期PTC患者发生CLNM的高危因素,当具备上述某项或某几项危险因素时,可行p CND。
Objective To explore the risk factors of central lymph node metastasis (CLNM) in stage c N0 papillary thyroid carcinoma (PTC). Methods The clinicopathological data of 94 patients with stage cN0 PTC who underwent preventive central zone lymph node dissection (pCND) from March to July 2014 in Guangdong Provincial People’s Hospital were retrospectively analyzed. Results Postoperative pathological examination confirmed that CLNM occurred in 94 cases (45.7%). The results of multivariate analysis showed that the incidence of CLNM was significantly higher in patients younger than 45 years old with B ultrasound lesion close to the anterior, tumor diameter> 2 cm, extracapsular invasion and p CND lymph node count more than 3 (P <0.05). Conclusions Age <45 years old, B ultrasound lesions near the front and tumor diameter> 2 cm are all risk factors of CLNM in patients with PTC at stage cN0, and pCND is feasible when one or more of the above risk factors are involved.