吴婷婷,张 云,戴佳奇.pN1期甲状腺乳头状癌术后复发危险因素分析[J].肿瘤学杂志,2018,24(4):318-322.
pN1期甲状腺乳头状癌术后复发危险因素分析
Risk Factors for Recurrence in Patients with Papillary Thyroid Carcinoma of pN1
投稿时间:2017-03-07  
DOI:10.11735/j.issn.1671-170X.2018.04.B006
中文关键词:  甲状腺乳头状癌  淋巴结转移  复发
英文关键词:papillary thyroid carcinoma  lymph nodes metastasis  recurrence
基金项目:
作者单位
吴婷婷 上海市第十人民医院甲状腺中心同济大学医学院甲状腺疾病研究所 
张 云 上海市第十人民医院甲状腺中心同济大学医学院甲状腺疾病研究所 
戴佳奇 上海市第十人民医院甲状腺中心同济大学医学院甲状腺疾病研究所 
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中文摘要:
      摘 要:[目的] 探讨pN1期甲状腺乳头状癌术后复发的危险因素。[方法]回顾性分析380例手术pN1期甲状腺乳头状癌患者的临床病理特征,及其与术后复发的关系。[结果]380例患者中术后20例(5.3%)出现肿瘤复发,复发时间10.9±5.2个月。单因素分析显示多发病灶、被膜外侵犯、转移淋巴结数>5个以及淋巴结转移率≥0.4与肿瘤复发有关(P<0.05),而年龄、性别、原发肿瘤大小、是否为双侧病变、是否合并慢性淋巴细胞性甲状腺炎以及BRAFV600E基因突变与肿瘤复发无关(P>0.05)。多因素分析显示,被膜外侵犯和淋巴结转移率≥0.4是肿瘤复发的独立危险因素(P<0.05)。复发患者中,复发部位以Ⅱ区淋巴结最为常见,Ⅵ区淋巴结和残余腺体少见。[结论]被膜外侵犯、淋巴结转移率≥0.4与肿瘤复发有关,此类患者术后需加强随访。术前需要加强对Ⅱ区淋巴结的评估。
英文摘要:
      Abstract:[Objective] To evaluate the risk factors of recurrence in patients with pN1 papillary thyroid carcinoma(PTC) after operation.[Methods] The clinical data of 380 patients with pN1 PTC receiving surgical treatment were retrospectively reviewed. The clinicopathological characteristics and risk factors of recurrence were analyzed. [Results] Among 380 patients,20(5.3%) developed recurrence with a time interval of 10.9±5.2 months. Univariate analysis showed that the recurrence was associated with multifocality,extrathyroid invasion,metastatic LNs≥5,and LN metastatic ratio(LNR) ≥0.4(all P<0.05);while not associated with age,gender,tumor size,bilaterality,Hashimoto’s thyroiditis and BRAFV600E mutation. Multivariate analysis showed that extrathyroid invasion and LNR≥0.4 were independent risk factors for recurrence(P<0.05). Among 20 patients with recurrence,the most common sites of recurrence were lateral cervical lymph nodes(level Ⅱ),while recurrence at central compartment lymph nodes(level Ⅵ) and residual thyroid was rare.[Conclusion] Extrathyroid invasion and LN metastatic ratio ≥0.4 are related with recurrence in patients with pN1 PTC,and level Ⅱ LNs are most common sites for recurrence.
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