| 安文超,龚元荷,于文斌.甲状腺乳头状癌Ⅵb区淋巴结转移相关因素分析[J].肿瘤学杂志,2025,31(12):1064-1068. |
| 甲状腺乳头状癌Ⅵb区淋巴结转移相关因素分析 |
| Factors Associated with Lymph Node Metastasis in Zone Ⅵb of Papillary Thyroid Carcinoma |
| 投稿时间：2024-10-31 |
| DOI：10.11735/j.issn.1671-170X.2025.12.B009 |
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| 中文关键词: 甲状腺肿瘤 乳头状癌 Ⅵb区淋巴结 淋巴结转移 |
| 英文关键词:thyroid neoplasms papillary carcinoma zone Ⅵb lymph node lymph node metastasis |
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| 中文摘要: |
| 摘 要：［目的］ 探讨甲状腺乳头状癌（papillary thyroid carcinoma，PTC） Ⅵb区淋巴结转移的相关因素。［方法］ 收集2024年4月至2024年12月北京大学肿瘤医院内蒙古医院收治的82例PTC患者的临床病理资料，分析相关临床病理因素与Ⅵb区淋巴结转移的关系，以及Ⅵa区淋巴结转移与Ⅵb区淋巴结转移之间的关系。［结果］ 82例PTC的患者中，Ⅵa区淋巴结转移率为51.2%，Ⅵb区淋巴结转移率为30.5%，28.0%的患者同时存在Ⅵa、Ⅵb区淋巴结转移；有、无Ⅵa区淋巴结转移的患者中，Ⅵb区淋巴结转移率分别为54.8%、5.0%（P＜0.001）。单因素分析结果显示，肿瘤直径、被膜侵犯、Ⅵa区淋巴结转移、喉前淋巴结转移、气管前淋巴结转移与Ⅵb区淋巴结转移相关（P＜0.05）。多因素分析结果显示，有喉前淋巴结转移（OR=30.046，95%CI：2.767~326.246，P=0.005）和Ⅵa区淋巴结转移（OR=15.434，95%CI：2.575~92.493，P=0.003）是Ⅵb区淋巴结转移的独立危险因素。Ⅵa区转移淋巴结的数量、喉前转移淋巴结的数量以及两者联合预测Ⅵb区淋巴结转移的受试者工作特征曲线下面积分别为0.750（95%CI：0.633~0.868）、0.615（95%CI：0.457~0.772）和0.815（95%CI：0.723~0.907）。［结论］ PTC患者存在喉前淋巴结、Ⅵa区淋巴结转移时，高度提示Ⅵb区淋巴结转移，可对具有高危因素的患者常规行Ⅵb区淋巴结清扫。 |
| 英文摘要: |
| Abstract： ［Objective］ To explore the related factors of lymph node metastasis in zone Ⅵb of papillary thyroid carcinoma (PTC). ［Methods］ The clinical and pathological data of 82 patients with PTC admitted to Inner Mongolia Hospital of Peking University Cancer Hospital from April 2024 to December 2024 were collected. The relationship between the relevant factors and lymph node metastasis in zone Ⅵb， and between lymph node metastasis in zone Ⅵa and zone Ⅵb was analyzed. ［Results］ Among the 82 patients with PTC， the lymph node metastasis rate of zone Ⅵa and zone Ⅵb was 51.2% and 30.5%，and 28.0% for both zone. Among patients with and without lymph node metastasis in zone Ⅵa， the rate of lymph node metastasis in zone Ⅵb was 54.8% and 5.0%， respectively (P<0.001). The results of univariate analysis showed that tumor diameter， perineural invasion， lymph nodes in zone Ⅵa， pre-laryngeal lymph nodes， and pre-tracheal lymph nodes were associated with lymph node metastasis in zone Ⅵb(P<0.05). Ultivariate analysis showed that pre-laryngeal lymph nodes (OR=30.046， 95%CI： 2.767~326.246， P=0.005) and metastatic lymph nodes in zone Ⅵa (OR=15.434， 95%CI： 2.575~92.493， P=0.003) were independent risk factors for metastatic lymph nodes in zone Ⅵb. The areas under the curve of the receiver operating characteristic (ROC) curves of the number of metastatic lymph nodes in zone Ⅵa， the number of metastatic lymph nodes in the anterior larynx， and the combination of the two for predicting metastasis of lymph nodes in zone Ⅵb were 0.750 (95%CI： 0.633~0.868)， 0.615 (95%CI： 0.457~0.772) and 0.815 (95%CI： 0.723~0.907). ［Conclusion］ Metastasis of pre-laryngeal lymph nodes and zone Ⅵa lymph in PTC patients highly suggests zone Ⅵb lymph node metastasis, which would be an indication for zone Ⅵb lymph node dissection. |
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