103例甲状腺微小乳头状癌中央淋巴结转移的预测因素分析

Analysis of Predictive Factors for Central Lymph Node Metastasis in 103 Cases of Micropapillary Thyroid Carcinoma

摘要: 目的：回顾性研究甲状腺微小乳头状癌(papillary thyroid microcarcinoma, PTMC)发生中央区淋巴结转移(Central lymph node metastasis, CLNM)的影响因素。方法：收集2019年12月至2022年12月期间就诊于乌鲁木齐市中医院并经病理诊断为PTMC的患者103例，分析其性别、年龄、民族、体重指数、TSH值、肿瘤直径、被膜侵犯、微钙化灶、癌灶数量、有无合并症与CLNM的相关性。结果：PTMC发生CLNM率为39.87% (41/103)，经单因素分析，性别、年龄、肿瘤直径、微钙化灶及癌灶数量是PTMC发生CLNM的危险因素(P < 0.05)；Logistic回归分析结果显示，性别、年龄、肿瘤直径、被膜侵犯以及多发癌灶是PTMC发生CLNM的危险因素(P < 0.05)。结论：可将性别、年龄、民族、体重指数、TSH值、肿瘤直径、被膜侵犯、微钙化灶、癌灶数量、有无合并症作为量化风险评估PTMC发生CLNM的预测因素，为进一步选择适合治疗方案提供参考。

Abstract: Objective: To retrospectively study the influencing factors of central lymph node metastasis (CLNM) in papillary thyroid microcarcinoma (PTMC). Methods: 103 patients who attended Urumqi Hospital of Traditional Chinese Medicine and were diagnosed as PTMC by pathology between December 2019 and December 2022 were collected, and the correlation between gender, age, ethnicity, body mass index, TSH value, tumor diameter, peritumoral invasion, microcalcified foci, the number of cancer foci, the presence of comorbidities and CLNM was analyzed. Results: The incidence of CLNM in PTMC was 39.87% (41/103), and by univariate analysis, gender, age, tumor diameter, microcalcified foci, and the number of cancer foci were the risk factors for the occurrence of CLNM in PTMC (P < 0.05); logistic regression analysis showed that gender, age, tumor diameter, perineural invasion, and multiple cancer foci were the risk factors for the occurrence of CLNM in PTMC (P < 0.05). Conclusion: Gender, age, ethnicity, body mass index, TSH value, tumor diameter, peritumoral invasion, microcalcified foci, number of cancer foci, and comorbidities can be used as predictive factors for quantitative risk assessment of the occurrence of CLNM in PTMC, which can provide a reference for further selection of suitable treatment options.