A Meta-analysis of risk factors related to the lymph nodes posterior to the right recurrent laryngeal nerve in thyroid micropapillary carcinoma
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摘要: 目的 通过Meta分析探讨甲状腺微小乳头状癌(PTMC)右侧喉返神经后方(Ⅵb区)淋巴结转移的危险因素。方法 检索国内外文献数据库中PTMC喉返神经后方淋巴结转移相关的文献, 检索截止时间是2020年6月, 由两名研究者筛选文献、提取数据后, 采用Revman5.3软件进行Meta分析。结果 共纳入5篇文章, 共计1884例研究对象, 研究结果显示: PTMC Ⅵb区淋巴结转移率为10.8%(203/1884), 转移危险因素包括患者年龄 < 45岁, 男性, 右叶肿瘤直径≥0.5 cm, 侵出包膜, Ⅵa淋巴结转移。结论 对PTMC有Ⅵb区淋巴结转移高危因素的患者应该行包含Ⅵb区淋巴结在内彻底的淋巴结清扫。Abstract: Objective To evaluate the risk factors for metastasis of the lymph nodes posterior to the right recurrent laryngeal nerve in thyroid micropapillary carcinoma(PTMC) by Meta-analysis.Methods We searched domestic and foreign databases for relevant studies published up to June, 2020. Two independent reⅥewers performed literature screening and data extraction according to the inclusion and exclusion criteria. Then, Meta-analysis was performed using Revman 5.3 software.Results A total of 5 articles were included, with a total of 1884 subjects.The results of the study showed that the rate of lymph node metastasis in PTMC Ⅵb area was 10.8% (203/1884). The risk factors for metastasis included patients' age < 45 years old, male, right lobe tumor Diameter ≥0.5 cm, invading the envelope, Ⅵa lymph node metastasis.Conclusion Ⅵb lymph node dissection is recommended when there exists age < 45 years, male sex, right lobe tumor≥0.5 cm, capsular invasion or Ⅵa lymph node metastasis.
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Key words:
- thyroid neoplasms /
- lymphatic metastasis /
- neck dissection /
- recurrent laryngeal nerve /
- Meta-analysis
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表 2 Ⅵb区淋巴结转移危险因素
危险因素 OR 95%CI P 年龄(< 45岁) 1.72 1.29~2.28 0.01 男性 2.15 1.55~2.98 < 0.01 右叶肿瘤直径(≥ 0.5 cm) 2.82 1.82~4.36 < 0.01 肿瘤位置(右叶上级) 1.12 0.59~2.12 0.73 侵出包膜 3.78 2.35~6.08 < 0.01 腺外侵犯 1.84 0.74~4.58 0.19 多灶性 2.16 0.89~5.21 0.09 桥本甲状腺炎 0.99 0.65~1.53 0.98 Ⅵa区淋巴结转移 7.40 4.88~11.21 <0.01 
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