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目的分析甲状腺结节的临床与病理特征,寻找甲状腺癌诊断及其发生淋巴结转移的可能因素。方法行手术治疗的甲状腺结节患者1358例,对其年龄、性别、高血压和甲亢病史、癌灶大小、双侧癌、多灶癌、浸润包膜及合并桥本甲状腺炎等特征进行统计学分析。结果 1358例患者中,女性患者占大多数(约80.3%),45岁以上患者占70.0%。其中,264例为甲状腺癌。对良恶性结节患者进行临床特征分析后发现,年龄及高血压病史与恶性结节的发生相关(P<0.05),年龄<45岁为甲状腺癌的独立危险因素。所有甲状腺癌患者中,37.5%的患者有颈部淋巴结转移,其发生与年龄、高血压、癌灶大小和浸润包膜相关(P<0.05),而年龄<45岁和癌灶浸润包膜为甲状腺癌发生颈部淋巴结转移的独立危险因素,在甲状腺乳头状癌患者中也同样如此。结论对于年龄<45岁的甲状腺结节患者怀疑甲状腺癌者应密切观察或早期干预,对其中癌灶浸润包膜者给予颈部淋巴结清扫,可能让患者获得更好的预后。
Objective To analyze the clinical and pathological features of thyroid nodules and to find out the possible causes for the diagnosis of thyroid cancer and its occurrence of lymph node metastasis. Methods A total of 1358 cases of thyroid nodules undergoing surgery were enrolled in this study. Their age, gender, history of hypertension and hyperthyroidism, size of cancer, bilateral cancer, multifocal cancer, infiltration envelope and Hashimoto’s thyroiditis were statistically analyzed analysis. Results Of the 1358 patients, female patients accounted for the majority (about 80.3%) and those over 45 years old accounted for 70.0%. Among them, 264 cases of thyroid cancer. The clinical features of patients with benign and malignant nodules showed that age and history of hypertension were associated with the occurrence of malignant nodules (P <0.05), and those aged <45 years were independent risk factors for thyroid cancer. Among all thyroid cancer patients, 37.5% had cervical lymph node metastasis, which was associated with age, hypertension, size of tumor and infiltrating capsule (P <0.05), but age <45 years and tumor capsule infiltrating An independent risk factor for cervical lymph node metastasis in thyroid cancer is also found in patients with papillary thyroid carcinoma. CONCLUSIONS: Thyroid cancer patients with thyroid nodules aged <45 years should be closely observed or treated with early intervention. Patients with lymph node dissection should be given a better prognosis.