伴有侧颈区淋巴结转移的甲状腺乳头状癌患者不同年龄组的临床特征分析

张帅; 蒋孝会

doi:10.13201/j.issn.1001-1781.2018.17.007

伴有侧颈区淋巴结转移的甲状腺乳头状癌患者不同年龄组的临床特征分析

张帅¹,
蒋孝会^2, ,

- 1. 湖北省肿瘤医院头颈外科(武汉, 430079);
- 2. 湖北省肿瘤医院妇瘤科

详细信息

通讯作者: 蒋孝会,E-mail:jiangh1115@126.com

中图分类号: R736.1

收稿日期: 2018-05-17

Clinical features of papillary thyroid carcinoma patients associated with lateral lymph node metastasis in different ages

ZHANG Shuai¹,
JIANG Xiaohui^2, ,

- 1. Department of Head and Neck Surgery, Hubei Cancer Hospital, Wuhan, 430079, China;
- 2. Department of Gynecologic Oncology, Hubei Cancer Hospital

More Information

Corresponding author: JIANG Xiaohui, E-mail: jiangh1115@126.com

Received Date: 17 May 2018

摘要

摘要: 目的：探讨伴有侧颈区淋巴结转移（LLNM）的甲状腺乳头状癌（PTC）患者不同年龄组的临床特征。方法：165例伴有LLNM的首诊PTC患者被纳入研究并分为3个组（22~<30岁组，30~<45岁组和45~65岁组），分析3组在性别、颈淋巴结转移数（率）、肿瘤最大直径、多灶性、术前血清促甲状腺激素（TSH）、被膜侵犯及腺外侵犯等方面的临床特征。结果：患者中位年龄为39岁。肿瘤最大直径>1 cm，多灶性，术前血清TSH水平在3组间无明显差异。22~<30岁组中女性患者比例均高于其他2组（均P<0.05）；45~65岁组双侧病灶率高于22~<30岁组（P<0.01）；22~<30岁组和30~<45岁组被膜及腺外侵犯率均低于45~65岁组（均P<0.05）；22~<30岁组伴有桥本甲状腺炎的比例均高于其他2组（均P<0.05）；22~<30岁组中央区淋巴结转移数>3个的患者比例均高于其他2组（均P<0.01），同时30~<45岁组患者比例也同样高于45~65岁组（P<0.05）；中央区淋巴结转移率>0.35时，30~<45岁组患者比例明显高于其他2组（均P<0.05）。侧颈区淋巴结转移数>6个时，22~<30岁组患者比例明显高于其他2组（均P<0.01）；侧颈淋巴结转移率>0.33时，45~65岁组患者比例低于其他2组（均P<0.05）。22~<30岁组颈部总淋巴结转移数>11个时的患者比例显著高于其他2组（均P<0.01）；30~<45岁组的患者比例也高于45~65岁组（P<0.05）。颈部总淋巴结转移率>0.22时，45~65岁组患者比例明显低于其他2组（均P<0.01）。结论：在伴侧颈区淋巴结转移的PTC患者中女性患者比例较高，大多数患者肿瘤最大直径超过1 cm。22~<30岁组患者伴有桥本甲状腺炎比例高，颈淋巴结转移数量也较多。30~<45岁组中央区淋巴结高转移率较为常见。45~65岁组患者更易出现双侧病灶，肿瘤易侵犯被膜及腺外侵犯。伴有LLNM的PTC患者中年龄越大其颈部总的淋巴结转移数及转移率却相对较低。
- 甲状腺乳头状癌 /
- 侧颈区淋巴结转移 /
- 年龄 /
- 临床特征
Abstract: Objective: To explore the clinical features of papillary thyroid carcinoma(PTC) patients associated with lateral lymph node metastasis(LLNM) in different ages. Method: One hundred and sixty-five PTC patients associated with LLNM were included in the study and divided into three groups(22-<30 y, 30-<45 y and 45-65 y). The gender, the number and the ratio of neck lymph node metastasis, maximum tumor diameter, multifocality, preoperative serum thyroid stimulating hormone(TSH), the capsular invasion, extrathyroidal extension and other clinical features in different ages were analyzed. Result: The median age of the patients was 39 years. There were no significant differences in the maximum tumor diameter >1 cm, multifocality and preoperative serum TSH level among the three groups. The proportion of female patients in 22-<30 y group was higher than the other two groups(all P<0.05). The rate of bilateral lesions in 45-65 y group was higher than 22-<30 y group (P<0.01). The rates of the capsular invasion and extrathyroidal extension in 22-<30 y group and 30-45 group were similarly lower than 30-<45 y group(P<0.05). The proportion of the 22-<30 y group coexistent with Hashimoto thyroiditis was higher than the other two groups(P<0.05). When the number of central lymph node metastasis(CLNM) >3, the proportion of 22-<30 y group were higher than the other two groups(all P<0.01), the 30-<45 y group was the same as higher than 45-65 y group(P<0.05); When the ratio of CLNM>0.35, the proportion of 30-<45 y group was significantly higher than the other two groups(all P<0.05). When the number of LLNM>6, 22-<30 y group was significantly higher than the other two groups; when the ratio of LLNM>0.33, 45-65 y group was lower than the other two groups(all P<0.05). The total lymph node metastasis>11, the proportion of 22-<30 y group was significantly higher than the other two groups(all P<0.01), meanwhile 30-<45 y was higher than 45-65 y group(P<0.05); when the ratio of total lymph node metastasis>0.22, 45-65 y group was significantly higher than the other two groups(all P<0.01). Conclusion: There is a high proportion of female and maximum tumor diameter over 1cm in PTC associated with LLNM. The proportion of coexistent with Hashimoto thyroiditis and the number of lymph node metastasis are much higher in 22-<30 y group. The higher ratio of CLNM is much more common in 30-<45 group. The bilateral lesions are more likely to occur in 45-65 y group, and meanwhile the tumor is more easier to invade the capsular and extrathyroidal construction. The number and the ratio of total lymph node metastasis might be lower in PTC associated with LLNM of older patients.
- papillary thyroid carcinoma /
- lateral lymph node metastasis /
- age /
- clinical features

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