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- 2018
甲状腺乳头状癌颈部中央区淋巴结转移的危险因素分析
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Abstract:
摘要 目的:由于仍缺乏对甲状腺乳头状癌(PTC)中央区淋巴结转移(CLNM)准确的术前诊断方法,故目前对于是否应行预防性中央区淋巴结清扫术(CLND)仍有争议.本研究旨在探讨甲状腺乳头状癌颈部CLNM的相关危险因素,为进行CLND提供理论依据.方法:选取行颈部CLND并最终病理确诊为PTC的患者140例,将患者的各项临床病理相关因素作为自变量,以CLNM作为因变量,应用卡方检验及二分类变量Logistic回归模型进行分析,以期分析甲状腺乳头状癌CLNM的高危因素.结果:恶性肿瘤数目(P=0.277)、伴结节性甲状腺肿(P=0.811)、伴甲状腺良性肿瘤(P=0.152)、伴桥本氏病(P=0.399)、术前彩超显示低回声(P=0.174)与中央区淋巴结转移无相关性,年龄(P=0.037)、性别(P=0.008)、肿瘤大小(P=0.004)及彩超提示微钙化(P=0.006)与CLNM有关,且年龄(P=0.016, OR=0.383)、性别(P=0.016, OR=3.167)、肿瘤大小(P=0.003, OR=3.244)以及彩超提示微钙化(P=0.006, OR=3.148)是其独立危险因素.结论:在甲状腺乳头状癌发生CLNM的患者中,彩超提示微钙化、肿瘤大小、年龄以及性别均作为独立危险因素,临床决策是否行预防性CLND时应充分评估上述多个独立危险因素,并综合考虑作出合理的个性化诊疗方案.
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