[单侧甲状腺乳头状癌对侧中央淋巴结转移的危险因素]。

Q4 Medicine
J H Wang, Z H Wang, Y B Chen, Y X Sun
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The relationship between the demographic characteristics, clinicopathological characteristics and other indicators of the two groups of patients and their metastases of Cont-CLNs was analyzed. Univariate analysis, multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were used to screen the risk factors for Cont-CLNs metastasis. Postoperative follow up was performed in the patients. <b>Results:</b> Univariate analysis showed that age, gender, combined Hashimoto's thyroiditis, extranodal invasion, pretracheal and prelaryngeal lymph node metastasis, ipsilateral central lymph nodes (Ipsi-CLNs) metastasis on the affected side, lateral cervical lymph node metastasis on the affected side, lesion location, and tumor diameter were associated with Cont-CLNs metastasis (all <i>P</i> values<0.05). 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引用次数: 0

摘要

目的:探讨单侧甲状腺乳头状癌(PTC)对侧中央淋巴结(con - clns)转移的危险因素,指导临床手术范围的选择。方法:回顾性分析2020年9月至2022年4月在四川省肿瘤医院行甲状腺全切除术及双侧中央淋巴结清扫术,术后病理证实为单侧PTC的362例患者的资料。其中男性87例,女性275例,年龄11 ~ 76岁。根据是否存在con - cln转移分为转移组(115例)和非转移组(247例)。分析两组患者的人口学特征、临床病理特征等指标与con - clns转移的关系。采用单因素分析、多因素logistic回归分析和受试者工作特征(ROC)曲线分析筛选con - clns转移的危险因素。术后随访。结果:单因素分析显示,年龄、性别、合并桥本甲状腺炎、结外浸润、气管前及喉前淋巴结转移、患侧同侧中央淋巴结(Ipsi-CLNs)转移、患侧颈侧淋巴结转移、病变部位、肿瘤直径与con - clns转移相关(P值均为P值)。控制- clns转移的危险因素包括男性、Ipsi-CLNs转移、气管前和喉前淋巴结转移、肿瘤位于峡部或单侧肺叶加峡部。对于有危险因素的单侧PTC,可以考虑进行con - cln解剖。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Risk factors for contralateral central lymph node metastasis in unilateral papillary thyroid carcinoma].

Objective: To explore the risk factors for contralateral central lymph nodes (Cont-CLNs) metastasis of unilateral papillary thyroid carcinoma (PTC) and to guide the decision-making of clinical surgical scope. Methods: The data of 362 patients who underwent total thyroidectomy and bilateral central lymph node dissection at the Sichuan Cancer Hospital from September 2020 to April 2022 and were confirmed as unilateral PTC by postoperative pathology were retrospectively analyzed. Among them, 87 were male and 275 were female, aged from 11 to 76 years. According to whether presence of Cont-CLNs metastasis, they were divided into the metastasis group (115 cases) and the non-metastasis group (247 cases). The relationship between the demographic characteristics, clinicopathological characteristics and other indicators of the two groups of patients and their metastases of Cont-CLNs was analyzed. Univariate analysis, multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were used to screen the risk factors for Cont-CLNs metastasis. Postoperative follow up was performed in the patients. Results: Univariate analysis showed that age, gender, combined Hashimoto's thyroiditis, extranodal invasion, pretracheal and prelaryngeal lymph node metastasis, ipsilateral central lymph nodes (Ipsi-CLNs) metastasis on the affected side, lateral cervical lymph node metastasis on the affected side, lesion location, and tumor diameter were associated with Cont-CLNs metastasis (all P values<0.05). Multivariate revealed that: each of male gender, Ipsi-CLNs metastasis, pretracheal and prelaryngeal lymph node metastasis, cancer focus location in the isthmus, and unilateral glandular lobe combined with isthmus was an independent risk factor for Cont-CLNs metastasis. For predicting the metastasis risk of Cont-CLNs, the optimal critical value of the number of metastasized Ipsi-CLNs was 2.5, and the area under the ROC curve (AUC) was 0.700; the optimal cut-off value of the number of metastasized pretracheal and prelaryngeal lymph nodes was 1, with an AUC of 0.681. The AUC of gender was 0.630, and the AUC of the cancer lesion location was 0.545. Multivariate ROC curve analysis for Cont-CLNs metastasis based on gender, the number of metastasized Ipsi-CLNs, the number of metastasized pretracheal and prelaryngeal lymph nodes, and the location of cancer foci showed an AUC of 0.794. The patients were followed up until January 2025. Excluding 3 cases with hoarseness caused by recurrent laryngeal nerve invasion before the operation and 3 cases with resection and reconstruction of invaded recurrent laryngeal nerves discovered during the operation, there were no patients with permanent recurrent laryngeal nerve palsy after the operation. There were 3 cases with postoperative permanent hypoparathyroidism. There no patients with postoperative recurrence. Conclusion: Risk factors for Cont-CLNs metastasis include male sex, Ipsi-CLNs metastasis, pretracheal and prelaryngeal lymph nodes metastasis, and tumor location in the isthmus or unilateral lobe plus isthmus. In unilateral PTC with the risk factors, Cont-CLNs dissection may be considered.

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来源期刊
CiteScore
0.40
自引率
0.00%
发文量
12432
期刊介绍: Chinese journal of otorhinolaryngology head and neck surgery is a high-level medical science and technology journal sponsored and published directly by the Chinese Medical Association, reflecting the significant research progress in the field of otorhinolaryngology head and neck surgery in China, and striving to promote the domestic and international academic exchanges for the purpose of running the journal. Over the years, the journal has been ranked first in the total citation frequency list of national scientific and technical journals published by the Documentation and Intelligence Center of the Chinese Academy of Sciences and the China Science Citation Database, and has always ranked first among the scientific and technical journals in the related fields. Chinese journal of otorhinolaryngology head and neck surgery has been included in the authoritative databases PubMed, Chinese core journals, CSCD.
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