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目的探讨临床颈侧区淋巴结阴性(cN0)甲状腺乳头状微小癌(PTMC)中央区淋巴结转移相关的临床病理因素。方法回顾分析2007年1月-2010年1月初治的109例颈侧区cN0 PTMC患者的资料,探讨与PTMCⅥ区淋巴结转移相关的临床病理因素。结果 109例PTMC患者中Ⅵ区淋巴结转移率为31.2%(34/109)。单因素分析发现肿瘤最大径(≥5 mm)、多发病灶与PTMCⅥ区淋巴结转移显著相关(P<0.05);Logistic回归模型多因素分析显示肿瘤最大径(≥5 mm)、多发病灶为PTMCⅥ区淋巴结转移的独立危险因素(P<0.05)。结论 PTMC中原发灶大小(≥5 mm)、多发病灶患者Ⅵ区淋巴结转移率显著升高。对于这两类PTMC患者需常规行Ⅵ区淋巴结清扫。
Objective To investigate the clinicopathological factors related to lymph node metastasis in the central cervical lymph node-negative (cN0) papillary thyroid carcinoma (PTMC). Methods The data of 109 cases of cN0 PTMC in the lateral neck region from January 2007 to January 2010 were retrospectively analyzed to investigate the clinicopathological factors related to lymph node metastasis in the region of PTMC Ⅵ. Results The lymph node metastasis in Ⅵ of 109 PTMC cases was 31.2% (34/109). Univariate analysis showed that the maximum tumor diameter (≥5 mm), multiple lesions and PTMC Ⅵ lymph node metastasis were significantly correlated (P <0.05); multivariate analysis showed that the maximum diameter of tumor (≥5 mm), multiple lesions of PTMC Ⅵ lymph node Independent risk factors for metastasis (P <0.05). Conclusions The size of primary tumor (≥5 mm) in PTMC and the rate of lymph node metastasis in grade Ⅵ in patients with multiple lesions were significantly higher than those in control group. For these two types of patients with PTMC routine Ⅵ regional lymph node dissection.