| 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 |
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| 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: |
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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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