甲状腺乳头状癌中央区淋巴结转移的影响因素分析

目的 探讨甲状腺乳头状癌中央区淋巴结转移（CLNM）的临床特点及影响因素。方法 收集2017年2月至2018年6月在阜阳市人民医院首次细胞学诊断的甲状腺乳头状癌患者147例，术后病理均为甲状腺乳头状癌，按是否伴有CLNM，分为淋巴结转移组（CLNM组，45例）与淋巴结未转移组（nCLNM组，102例）。收集两组患者的一般资料、甲状腺功能实验室结果及甲状腺结节超声结果等，并进行比较分析。结果 两组患者性别、年龄、促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TGAb），甲状腺结节的边缘、微钙化、纵横比、最大径进行比较，差异均有统计学意义（P<0.05）；血清游离三碘甲状腺原氨酸（FT3）、血清游离四碘甲状腺原氨酸（FT4），甲状腺结节的质地、回声、孤立灶及TIRADS分类差异无统计学意义（P>0.05）。logistic回归分析显示，年龄（OR=1.054，95% CI：1.006~1.103）、性别（OR=6.499，95% CI：1.902~22.200）、TSH（OR=1.904，95% CI：1.395~2.598）、TGAb（OR=3.022，95% CI：1.005~9.084）、边缘（OR=11.483，95% CI：3.196~41.255）、纵横径比（OR=4.409，95% CI：1.508~12.890）及最大径（OR=1.894，95% CI：1.250~2.869）是甲状腺乳头状癌CLNM的影响因素（P<0.05）。结论 年龄、性别、TSH、TGAb、甲状腺结节边缘、纵横比及最大径可能是甲状腺乳头状癌CLNM的影响因素。

Analysis of influencing factors of central lymph node metastasis in papillary thyroid carcinoma

Objective To investigate the clinical characteristics and influencing factors of central lymph node metastasis (CLNM) in the papillary thyroid carcinoma. Methods The 147 patients with papillarythyroid carcinoma diagnosed by cytology for the first time in Fuyang People''s Hospital from February 2017 to June 2018 were collected, and the postoperative pathology confirmed papillary thyroid carcinoma. The patients were divided into lymphnode metastasis group (CLNM group, 45 cases) and non lymph node metastas group (nCLNM group, 107 cases) according to whether they had cervical lymph node metastasis. The general data of patients, thyroid function laboratory results and thyroid nodule ultrasound results were collected and compared. Results There were differences in gender, age, TSH, TPOAb, TGAb, thyroid nodule edge, microcalcification, aspect ratio and maximum meridian between the two groups(P<0.05), but there was no difference in FT3 and FT4, thyroid nodule texture, echo, solitary focus and TIRADS classification (P>0.05). Logistic regression analysis showed that age (OR=1.054,95%CI:1.006~1.103), gender (OR=6.499,95%CI:1.902~22.200), TSH (OR=1.904,95%CI:1.395~2.598), TGAb (OR=3.022,95%CI:1.005~9.084), edge (OR=11.483,95%CI:3.196~41.255), aspect ratio(OR=4.409,95%CI:1.508~12.890) and maximum diameter (OR=1.894,95%CI:1.250~2.869) were the influencing factors of CLNM in papillary thyroid carcinoma. Conclusion Age, gender, TSH, TGAb, thyroid nodule margin, aspect ratio and maximum diameter may be influencing factors for cervical central lymph node metastasis of papillary thyroid carcinoma.