外科理论与实践 ›› 2021, Vol. 26 ›› Issue (06): 528-531.doi: 10.16139/j.1007-9610.2021.06.014
樊金芳, 沈依, 詹维伟2, 陶玲玲, 李伟伟, 况李君, 周伟2()
收稿日期:
2021-06-09
出版日期:
2021-11-25
发布日期:
2022-07-27
通讯作者:
周伟
E-mail:zw11468@126.com
FAN Jinfang, SHEN Yi, ZHAN Weiwei2, TAO Lingling, LI Weiwei, KUANG Lijun, ZHOU Wei2()
Received:
2021-06-09
Online:
2021-11-25
Published:
2022-07-27
Contact:
ZHOU Wei
E-mail:zw11468@126.com
摘要:
目的:探讨峡部甲状腺微小乳头状癌(papillary thyroid microcarcinoma, PTMC)的临床病理特征。方法:回顾性分析经手术并经病理证实的477例PTMC临床病理资料,比较位于峡部与侧叶PTMC之间的差异。结果:多因素分析显示结节包膜接触(30.5%比10.4%,P=0.001)、淋巴结转移(lymph node metastasis,LNM)(42.7%比18.7%,P<0.001)在峡部与侧叶PTMC之间差异有统计学意义。与侧叶PTMC相比,峡部PTMC更易于出现同侧中央LNM(41.5%比17.5%,P<0.001)、同侧侧方LNM(8.5%比2.8%,P=0.022)和双侧中央LNM(12.2%比0.2%,P<0.001)以及对侧侧方LNM(3.7%比0,P<0.001)。结论:与侧叶PTMC相比,峡部PTMC有更高比例的包膜接触及LNM,建议行双侧中央淋巴结清扫。
中图分类号:
樊金芳, 沈依, 詹维伟, 陶玲玲, 李伟伟, 况李君, 周伟. 峡部甲状腺微小乳头状癌临床病理分析[J]. 外科理论与实践, 2021, 26(06): 528-531.
FAN Jinfang, SHEN Yi, ZHAN Weiwei, TAO Lingling, LI Weiwei, KUANG Lijun, ZHOU Wei. Clinicopathological analysis of papillary thyroid microcarcinoma in isthmus[J]. Journal of Surgery Concepts & Practice, 2021, 26(06): 528-531.
表1
峡部与侧叶PTMC临床病理特征的单因素分析比较(%)
指标 | 特征 | 峡部(n=82) | 侧叶(n=395) | χ2值 | P值 |
---|---|---|---|---|---|
性别 | 男 | 19(23.2) | 86(21.8) | 0.077 | 0.771 |
女 | 63(76.8) | 309(78.2) | |||
年龄(岁) | <45 | 33(40.2) | 170(43.0) | 0.217 | 0.713 |
≥45 | 49(59.8) | 225(57.0) | |||
结节最大径(mm) | <5 | 21(25.6) | 91(23.0) | 0.250 | 0.668 |
5~10 | 61(74.4) | 304(77.0) | |||
包膜 | 不接触 | 57(69.5) | 354(89.6) | 23.029 | <0.001 |
接触 | 25(30.5) | 41(10.4) | |||
病理LNM | 无转移 | 47(57.3) | 321(81.3) | 22.091 | <0.001 |
转移 | 35(42.7) | 74(18.7) | |||
usLNM | 无转移 | 65(79.3) | 355(89.9) | 7.258 | 0.014 |
转移 | 17(20.7) | 40(10.1) | |||
合并桥本甲状腺炎 | 无 | 64(78.0) | 346(87.6) | 5.125 | 0.035 |
有 | 18(22.0) | 49(12.4) |
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