甲状腺乳头状癌颈部中央区淋巴结转移数目对颈侧区淋巴结转移的预测价值
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摘要
目的探讨甲状腺乳头状癌颈部中央区淋巴结转移数目对颈侧区淋巴结转移的预测价值。方法回顾性分析2014年9月至2017年8月冀中能源峰峰集团总医院病理学检查确诊的131例甲状腺乳头状癌患者的病例资料,患者均行颈部中央区与颈侧区淋巴结清扫手术,统计颈部中央区淋巴结转移数目及其与颈侧区淋巴结转移的关系。结果颈部中央区淋巴结转移对颈侧区淋巴结转移的预测敏感度为65.93%,阳性预测值为66.67%。颈部中央区淋巴结转移数目的增加与颈侧区淋巴结转移率呈正相关(r=0.947,P=0.002)。以2、3、4枚为临界,颈部中央区淋巴结转移患者的颈侧区淋巴结转移率明显升高(P<0.05)。以5、6枚为临界,颈部中央区淋巴结转移患者的颈侧区淋巴结转移率无明显变化(P>0.05)。结论甲状腺乳头状癌患者颈部中央区淋巴结转数目对颈侧区淋巴结转移有较高的预测价值。
Objective To explore the predictive value of metastasis in central cervical lymph nodes for metastasis in lateral cervical region lymph nodes in patients with papillary thyroid carcinoma. Methods A retrospective analysis was carried out in 131 cases of thyroid papillary carcinoma confirmed by pathological diagnosis in this hospital during September 2014 to August 2017 had been carried out. The clinical data of thesepatients with central cervical lymph node dissection,statistical analysis on the relationship between central cervical lymph node metastasis and the number of neck lymph nodes with metastasis. Results The sensitivity of prediction of metastasis in central neck lymph nodes was 65. 93% for neck lymph nodes,and its positive predictive value was 66. 67%. The increase in transference rate was positively correlated with the number of neck lymph nodes with metastasis( r = 0. 947,P = 0. 002). As 2,3 and 4 for critical points,metastasis in central cervical lymph nodes in patients with cervical lymph node metastasis increased significantly( P < 0. 05). As 5 and 6 for critical point,metastais in central cervical lymph nodes in patients with cervical lymph node metastasis rate had no significant change( P > 0. 05). Conclusion In patients with papillary thyroid carcinoma having metastasis in cervical lymph nodes,the number of neck lymph nodes with metastasis has higher predictive value.
Objective To explore the predictive value of metastasis in central cervical lymph nodes for metastasis in lateral cervical region lymph nodes in patients with papillary thyroid carcinoma. Methods A retrospective analysis was carried out in 131 cases of thyroid papillary carcinoma confirmed by pathological diagnosis in this hospital during September 2014 to August 2017 had been carried out. The clinical data of thesepatients with central cervical lymph node dissection,statistical analysis on the relationship between central cervical lymph node metastasis and the number of neck lymph nodes with metastasis. Results The sensitivity of prediction of metastasis in central neck lymph nodes was 65. 93% for neck lymph nodes,and its positive predictive value was 66. 67%. The increase in transference rate was positively correlated with the number of neck lymph nodes with metastasis( r = 0. 947,P = 0. 002). As 2,3 and 4 for critical points,metastasis in central cervical lymph nodes in patients with cervical lymph node metastasis increased significantly( P < 0. 05). As 5 and 6 for critical point,metastais in central cervical lymph nodes in patients with cervical lymph node metastasis rate had no significant change( P > 0. 05). Conclusion In patients with papillary thyroid carcinoma having metastasis in cervical lymph nodes,the number of neck lymph nodes with metastasis has higher predictive value.
引文
[1]林启强,韩志江,舒艳艳,等.CT在评估甲状腺乳头状癌中央组淋巴结转移中的价值[J].中国临床医学影像杂志,2015,26(3):162-165,205.
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[4]彭琛,魏松锋,郑向前,等.1 401例甲状腺微小乳头状癌临床病理特征及中央区淋巴结转移危险因素分析[J].中国肿瘤临床,2016,43(3):95-99.
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[6]黄煜庆,温庆良,葛明华.甲状腺乳头状癌术前颈淋巴结转移评估技术研究进展[J].肿瘤学杂志,2017,23(1):65-70.
[7]张鹏,刘瑞磊,姚志成,等.甲状腺乳头状癌淋巴结转移规律及影响因素分析[J].中山大学学报(医学科学版),2017,38(1):85-88.
[8]刘文,程若川,苏艳军,等.2015版美国甲状腺协会指南c N0甲状腺乳头状癌手术方案合理性分析[J].中国实用外科杂志,2017,37(5):568-571.
[9]蔡业丰,陈恩东,倪纯珏,等.甲状腺乳头状癌颈部中央区淋巴结转移数目对颈侧区淋巴结转移的预测价值[J].中华肿瘤杂志,2015,29(8):628-631.
[10]郭凯,官青,李端树,等.甲状腺乳头状微小癌中央区淋巴结转移率与侧颈淋巴结转移关系研究[J].中国实用外科杂志,2015,35(1):110-113.
[11]刘松平,赵铭,王连臣,等.甲状腺癌颈部中央区淋巴结转移对侧区的影响[J].中国现代医学杂志,2016,26(7):108-111.
[2]高庆军,王南鹏,赵代伟.c N0期甲状腺乳头状微小癌中央区淋巴结隐性转移危险因素[J].中国普通外科杂志,2015,24(11):1504-1510.
[3]Park JS,Son KR,Na DG,et al.Performance of preoperative sonographic staging of papillary thyroid carcinoma based on the sixth edition of the AJCC/UICC TNM classification system[J].AJR Am J Roentgenol,2009,192(1):66-72.
[4]彭琛,魏松锋,郑向前,等.1 401例甲状腺微小乳头状癌临床病理特征及中央区淋巴结转移危险因素分析[J].中国肿瘤临床,2016,43(3):95-99.
[5]万登敏,韩兴权.高频彩超对甲状腺乳头状癌的诊断价值[J].临床和实验医学杂志,2011,10(15):1197-1198.
[6]黄煜庆,温庆良,葛明华.甲状腺乳头状癌术前颈淋巴结转移评估技术研究进展[J].肿瘤学杂志,2017,23(1):65-70.
[7]张鹏,刘瑞磊,姚志成,等.甲状腺乳头状癌淋巴结转移规律及影响因素分析[J].中山大学学报(医学科学版),2017,38(1):85-88.
[8]刘文,程若川,苏艳军,等.2015版美国甲状腺协会指南c N0甲状腺乳头状癌手术方案合理性分析[J].中国实用外科杂志,2017,37(5):568-571.
[9]蔡业丰,陈恩东,倪纯珏,等.甲状腺乳头状癌颈部中央区淋巴结转移数目对颈侧区淋巴结转移的预测价值[J].中华肿瘤杂志,2015,29(8):628-631.
[10]郭凯,官青,李端树,等.甲状腺乳头状微小癌中央区淋巴结转移率与侧颈淋巴结转移关系研究[J].中国实用外科杂志,2015,35(1):110-113.
[11]刘松平,赵铭,王连臣,等.甲状腺癌颈部中央区淋巴结转移对侧区的影响[J].中国现代医学杂志,2016,26(7):108-111.