山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (3): 120-124.doi: 10.6040/j.issn.1673-3770.1.2020.034

• 临床研究 • 上一篇    下一篇

甲状腺乳头状癌前上纵隔淋巴结转移临床病理特征初步分析

宁玉东, 蔡永聪, 孙荣昊, 姜健, 周雨秋, 税春燕, 汪旭, 郑王虎, 何天琪, 李超   

  1. 电子科技大学医学院附属肿瘤医院/四川省肿瘤研究所/四川省癌症防治中心/四川省肿瘤医院 头颈外科, 四川 成都 610041
  • 发布日期:2020-06-29
  • 通讯作者: 李超. E-mail: headneck@qq.com
  • 基金资助:
    四川省卫健委适宜技术推广项目-甲状腺结节规范化诊治技术项目推广(18SYJS07)

Preliminary analysis of the anterior superior mediastinal lymph node metastasis in thyroid papillary carcinoma

NING Yudong, CAI Yongcong, SUN Ronghao, JIANG Jian, ZHOU Yuqiu, SHUI Chunyan, WANG Xu, ZHENG Wanghu,   

  1. HE Tianqi, LI ChaoDepartment of Head and Neck surgery, Cancer Hospital Affiliate to School of Medicine, University of Electronic and Technology of China / Sichuan Institute of Cancer Research / Sichuan Cancer Prevention and Control Center / Sichuan Cancer Hospital, Chengdu 610041, Sichuan, China
  • Published:2020-06-29

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摘要： 目的 探讨肿瘤位置、最大直径及甲状腺外浸等临床病理特征与甲状腺癌前上纵隔淋巴结转移的关系。 方法 研究分析初次手术治疗的60例甲状腺乳头状癌患者临床及病理资料,运用检验临床病理特征与前上纵隔淋巴结阳性率的相关性。 结果 肿块位置、最大直径、数量、腺体外侵、受累腺叶数及Ⅵ区淋巴结转移等特征,以及患者年龄等相关因素中,只有VI区淋巴结对前上纵隔淋巴结状态有影响;60例患者前上纵隔淋巴结转移率为10/60(16.67%)。相关因素的前上纵隔淋巴结转移率对比:≥55岁vs <55岁(20% vs 16.36%, P<0.05);肿块位于下极 vs 上极 vs 中极(P>0.05);最大直径≥1.5 cm vs 最大直径<1.5 cm(18.18% vs 15.79, P>0.05);单灶 vs 多灶(21.88% vs 10.71%, P>0.05);单叶 vs 多叶(17.5% vs 15%, P>0.05);男性vs女性(20% vs 15.55%, P>0.05); Ⅵ区淋巴结阳性vs 阴性(24.43% vs 3.57%, P<0.05); 结论 总体来说,甲状腺乳头状癌前上纵隔淋巴结转移率较低。本研究发现VI区淋巴结状态可能与前上纵隔淋巴结转移相关,未来仍需大样本前瞻性的研究验证。

关键词: 甲状腺乳头状癌, 颈部淋巴结转移, 前上纵隔淋巴结, 中央区淋巴结, 肿瘤

Abstract: Objective To investigate the relationship between clinicopathological features such as the tumor location, maximum diameter, extranodal thyroid invasion, and anterior superior mediastinal lymph node metastasis of thyroid carcinoma. Methods We analyzed the clinical and pathological data of 60 patients with thyroid papillary carcinoma who were admitted to the Head and Neck Surgery Department at Sichuan Cancer Hospital for primary surgery between September 2018 and February 2019. The correlation between the clinical and pathological features and the positive rate of the anterior and upper mediastinal lymph nodes was analyzed using the chi-square test. Results Among the features of tumor location, maximum diameter, number, extranodal invasion, number of involved gland lobes and lymph node metastasis in region Ⅵ, as well as the age of patients and other relevant factors, only the lymph nodes in region Ⅵ affected the status of anterior superior mediastinal lymph nodes. Ten of the 60 patients(16.67%)had anterior superior mediastinal lymph node metastasis. The rates of anterior superior mediastinal lymph node metastasis were compared among the related factors: age > or equal to 55 years vs. younger than 55 years(20% vs. 16.36%; P<0.05); mass located in the lower pole vs. the upper pole vs. the middle pole(P>0.05); maximum diameter greater than or equal to 1.5 cm vs. less than 1.5 cm(18.18% vs. 15.79; p >0.05), single focus vs. multiple focus(21.88% vs. 10.71%; P>0.05), single vs. multiple leaves(17.5% vs. 15%; P>0.05); males vs. females(20% vs. 15.55%; P>0.05); positive vs. negative lymph nodes in area Ⅵ(24.43% vs. 3.57%; P<0.05). Conclusion The rate of anterior and upper mediastinal lymph node metastasis in thyroid papillary carcinoma is relatively low. In this study, it was found that the status of lymph nodes in Ⅵ region may be related to anterior superior mediastinal lymph node metastasis, and prospective studies with large samples are still needed in the future.

Key words: Papillary carcinoma of thyroid, Cervical lymph node metastasis, Anterior superior mediastinal lymph nodes, Lymph nodes in central region, Tumor

中图分类号: 

  • R736
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