早期分化型甲状腺癌中央区淋巴结转移与颈部侧区淋巴结转移的相关性
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1.空军军医大学第一附属医院超声医学科;2.空军军医大学卫生勤务教研室;3.空军军医大学第一附属医院甲乳血管外科

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西京医院学科助推计划XJZT18ML17


Clinical correlation between central lymph nodes metastasis and cervical lateral lymph nodes metastasis in early differentiated thyroid cancer
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Department of Ultrasound,the First Affiliated Hospital of Air Force Medical University,Xi’an

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    摘要:

    摘 要 目的 探讨早期分化型甲状腺癌患者中央区淋巴结转移与颈侧区淋巴结转移的相关性。方法 收集我院经病理确诊的分化型甲状腺癌患者65例,均行甲状腺全切除术加中央区淋巴结清扫术及颈侧区淋巴结清扫术。收集患者性别、年龄、原发灶大小、数目、是否突破包膜或侵犯组织等、中央区淋巴结转移数目、颈侧区淋巴结转移数目等,绘制拟合曲线分析中央区淋巴结转移比例与颈侧区淋巴结转移比例的相关性;绘制受试者工作特征(ROC)曲线分析中央区淋巴结转移比例与颈侧区淋巴结转移的相关性,预测颈侧区淋巴结转移比例。采用χ2检验分析中央区淋巴结转移的影响因素。结果 当中央区淋巴结转移比例达100%时,颈侧区淋巴结转移比例的均数±标准差为0.41±0.28(95%可信区间:0.30~0.52);而中央区淋巴结部分转移时颈侧区淋巴结转移比例均数±标准差为0.23±0.22(95%可信区间:0.16~0.30),二者呈正相关(相关系数=0.481,P<0.01);ROC曲线分析显示,中央区淋巴结转移比例预测颈侧区淋巴结转移比例的曲线下面积为0.738,(95% 可信区间:0.621~0.856,P<0.01)。女性、原发灶突破被膜或侵犯组织时更易出现中央区淋巴结全部转移(χ2=4.048、3.993,均P<0.05)。年龄与中央区淋巴结转移比例呈负相关(相关系数=-0.324,P<0.01)。结论 早期分化型甲状腺癌患者中央区淋巴结的转移比例与颈侧区淋巴结转移比例密切相关;女性、原发灶突破包膜或侵犯周围组织是中央区淋巴结全部转移的危险因素。

    Abstract:

    ABSTRACT Objective To explore the clinical correlation between the proportion of central lymph nodes(LNs) metastasis and the proportion of lateral cervical LNs metastasis in patients with early differentiated thyroid cancer.Methods 65 patients with differentiated thyroid cancer diagnosed by pathology in our hospital were collected. All patients underwent total thyroidectomy plus central lymph node dissection and lateral cervical lymph node dissection.Collect the patient''s gender, age, size and number of primary lesions, whether they have broken through the capsule or invaded tissues, the number of lymph node metastases in the central region, and the number of lymph node metastases in the lateral neck region,Construct a fitting curve to analyze the correlation between the proportion of lymph node metastasis in the central region and that in the lateral cervical region;The receiver operating characteristic (ROC) curve was drawn to analyze the correlation between the proportion of central lymph node metastasis and cervical lymph node metastasis, and to predict the proportion of cervical lymph node metastasis.χ2 test was used to analyze the influencing factors of central lymph node metastasis.Results When the proportion of LNs metastasis in the central zone reached 100%,the mean±standard deviation of the proportion of LNs metastasis in the lateral cervical zone was 0.41±0.28 (95% CI 0.30,0.52);otherwise,it was only 0.23±0.22 (95% CI 0.16 ,0.30). There is a significant positive correlation between the two,with a correlation coefficient of 0.481 (P <0.01);ROC curve analysis showed that the area under the curve of central lymph node metastasis ratio predicting cervical lymph node metastasis ratio was 0.738,(95% CI:0.621~0.856,P<0.01). Women and primary lesions are more likely to experience complete lymph node metastasis in the central region when they break through the capsule or invade tissues(χ2=4.048、3.993,均P<0.05).A negative correlation with age,with a correlation coefficient of -0.324 (P <0.01). Conclusion In early differentiated thyroid cancer,the proportion of central LNs metastasis is closely related to the proportion of lateral cervical LNs metastasis. Female gender and the fact that the primary tumor breaks through the capsule or invades surrounding tissues are risk factors for all central LNs metastases.

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巩雪,孙园园,万毅,孟慧敏,李松朋,李孟轩,孔静,丁嘉珺,王邑迪,于铭,王廷,樊菁.早期分化型甲状腺癌中央区淋巴结转移与颈部侧区淋巴结转移的相关性[J].临床超声医学杂志,2025,27(1):48-52

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  • 收稿日期:2024-04-13
  • 最后修改日期:2024-12-09
  • 录用日期:2024-07-09
  • 在线发布日期: 2025-02-07
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