甲状腺乳头状癌侧颈淋巴结转移的危险因素分析.pdfVIP

甲状腺乳头状癌侧颈淋巴结转移的危险因素分析 赵敬柱 高明 李亦工 于洋 张艳 程文元 杨力珍 潘毅 赵文川 【摘要】目的：探讨分析甲状腺乳头状癌患者侧颈淋巴结转移规律及处理方式。 方法：回顾性研究2006 年1 月至2010 年1 月首诊于我院的264 例甲状腺乳头状 癌患者的临床病理资料。应用Binary Logistic regression 模型对中央区淋巴结个数 进行最佳截点的筛选。应用Binary Logistic regression 模型分析影响侧颈区淋巴结 转移的危险因素。结果：本组 264 例甲状腺乳头状癌，中央区淋巴结转移率为 61.7%，侧颈Ⅱ区、Ⅲ区、Ⅳ区的淋巴结转移率分别为 30.5%、34.2%、39.7% 。 通过Binary Logistic regression 模型筛选出中央区淋巴结个数的最佳截点为0 。单 因素分析显示，双侧病灶、多发病灶、T 分期、侵犯程度、中央区淋巴结转个数 是影响甲状腺乳头状癌患者侧颈淋巴结转移的危险因素。进一步多因素分析显 示，中央区淋巴结转移个数是影响侧颈区淋巴结转移的独立危险因素（P＜0.05 ）。 结论：甲状腺乳头状癌患者中央区淋巴结发生转移，侧颈淋巴结发生转移的几率 显著增加。 【关键词】甲状腺乳头状癌 淋巴结转移 危险因素 Pattern and predictive factors of lateral cervical lymph node metastasis in papillary thyroid carcinoma Zhao Jing zhu, Gao Ming,Li Yigong, et al. Department of Thyroid Neck Tumors, Tianjin Medical University Cancer Hospital, Tianjin 300060, China Corresponding author: Gao Ming, E-mail: tijgaom@163.com 【Abstract 】Objective ：To study the patterns of lateral cervical lymph nodes metastasis, and to provide evidence for proper surgery of papillary thyroid carcinoma. Methods：From January 2006 to January 2010, 264 cases with papillary thyroid carcinoma were peformed thyroidectomy and neck dissection. Binary Logistic regression model was used to identify the optimal cut of the number of positive central lymph node. Potential factor were evaluated by binary Logistic regression ____________________ 作者单位：天津医科大学附属肿瘤医院甲状腺颈部肿瘤科（高 明、赵敬柱、李 亦工、于 洋、程文元、张 艳、杨力珍、赵文川），病理科（潘毅），天津市肿瘤 防治重点实验室，天津300060 通讯作者：高明，E-mail: tijgaom @163.com 340 analysis. Results: Among 264 patients with papillary thyroid carcinoma, the central lymph node metastasis rates was 61.7%. Most of the lateral lymph node metastases were in levels II, III, and IV, and the lymph node metastasis rates were 30.5%, 34.2%, 39.7%, respectively. Binary Logistic regression model showed that 0 was the optimal cu