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目的分析甲状腺乳头状癌患者中央区淋巴结转移的相关危险因素。方法对本院2013年4月~2015年10月收治的356例PTC患者的临床资料进行回顾性分析。调查分析患者病理特征(肿瘤大小、数量、位置等)、肿瘤分期、中央淋巴结转移、甲状腺特异性抗体及家族遗传病等情况,先用χ2检验进行单因素分析,再用Logistic回归对单因素分析结果中有统计学意义的因素行多因素分析。结果 356例PTC患者中,中央区淋巴结转移的发生率为51.97%(185/356)。单因素分析中,PTC患者中央区淋巴结转移与患者年龄、病灶大小、病灶数量、肿瘤分期及浸润被膜有显著关系(P<0.05)。而与性别、甲状腺特异性抗体、家族遗传病史无相关性(P>0.05)。多因素分析结果显示PTC患者年龄(<50周岁)、病灶大小(癌灶直径≥1.0cm)、病灶数量(多发病灶)及肿瘤分期(T3+T4)是影响中央淋巴结转移的危险因素,OR分别为0.922、2.460、0.397、0.703(P<0.05)。结论PTC患者年龄(<50周岁)、病灶大小(癌灶直径≥1.0cm)、病灶数量(多发病灶)及肿瘤分期(T3+T4)是影响中央淋巴结转移的危险因素,针对有此类危险因素的PTC患者,应行中央区淋巴结清扫术进行临床治疗。
Objective To analyze the related risk factors of lymph node metastasis in central papillary thyroid carcinoma patients. Methods The clinical data of 356 PTC patients admitted from April 2013 to October 2015 in our hospital were analyzed retrospectively. The patients’ histopathological features (tumor size, number, location, etc.), tumor stage, central lymph node metastasis, thyroid-specific antibodies and familial hereditary diseases were investigated and analyzed. Univariate analysis was performed with χ2 test and then with Logistic regression to univariate analysis Results were statistically significant factors in the multi-factor analysis. Results Among 356 PTC patients, the incidence of lymph node metastasis in the central area was 51.97% (185/356). In the univariate analysis, lymph node metastasis in the central area of patients with PTC was significantly associated with patient age, lesion size, number of lesions, tumor stage and infiltration of the capsule (P <0.05). No correlation was found with gender, thyroid-specific antibody and family history of disease (P> 0.05). Multivariate analysis showed that the age of patients with PTC (<50 years old), the size of the lesion (diameter ≥ 1.0 cm), the number of lesions (multiple lesions) and the stage of tumor (T3 + T4) were the risk factors of central lymph node metastasis. 0.960, 3.97, 0.703 (P <0.05). Conclusions The age of patients with PTC (<50 years old), the size of the lesion (diameter ≥ 1.0 cm), the number of lesions (multiple lesions) and the stage of tumor (T3 + T4) are the risk factors of central lymph node metastasis. Of PTC patients should be treated with central lymph node dissection for clinical treatment.