高级搜索

肿瘤位置等临床病理特征与分化型甲状腺癌淋巴结转移的关系

孙荣昊, 李超, 樊晋川, 王少新, 王薇, 刘坤, 兰小娇, 何雨歆

孙荣昊, 李超, 樊晋川, 王少新, 王薇, 刘坤, 兰小娇, 何雨歆. 肿瘤位置等临床病理特征与分化型甲状腺癌淋巴结转移的关系[J]. 肿瘤防治研究, 2014, 41(09): 993-997. DOI: 10.3971/j.issn.1000-8578.2014.09.009
引用本文: 孙荣昊, 李超, 樊晋川, 王少新, 王薇, 刘坤, 兰小娇, 何雨歆. 肿瘤位置等临床病理特征与分化型甲状腺癌淋巴结转移的关系[J]. 肿瘤防治研究, 2014, 41(09): 993-997. DOI: 10.3971/j.issn.1000-8578.2014.09.009
SUN Ronghao, LI Chao, FAN Jinchuan, WANG Shaoxin, WANG Wei, LIU Kun, LAN Xiaojiao, HE Yuxin. Relationship of Tumor Location and Other Clinicopathological Features with Differentiated Thyroid Cancer with Lymph Node Metastasis[J]. Cancer Research on Prevention and Treatment, 2014, 41(09): 993-997. DOI: 10.3971/j.issn.1000-8578.2014.09.009
Citation: SUN Ronghao, LI Chao, FAN Jinchuan, WANG Shaoxin, WANG Wei, LIU Kun, LAN Xiaojiao, HE Yuxin. Relationship of Tumor Location and Other Clinicopathological Features with Differentiated Thyroid Cancer with Lymph Node Metastasis[J]. Cancer Research on Prevention and Treatment, 2014, 41(09): 993-997. DOI: 10.3971/j.issn.1000-8578.2014.09.009

肿瘤位置等临床病理特征与分化型甲状腺癌淋巴结转移的关系

基金项目: 头颈部肿瘤防治四川省科技创新团队资助项目(2014TD0011);四川省科技攻关项目(2013SZ0017);四川省卫生厅科研项目资助(20120027&20140101)
详细信息
    作者简介:

    孙荣昊(1987-),男,硕士,住院医师,主要从事头颈肿瘤综合治疗研究

    通讯作者:

    李超,E-mail:sclichao@qq.com

  • 中图分类号: R736.1

Relationship of Tumor Location and Other Clinicopathological Features with Differentiated Thyroid Cancer with Lymph Node Metastasis

  • 摘要: 目的 探讨肿瘤位置、体积及甲状腺被膜浸润情况等临床病理特征与分化型甲状腺癌颈淋巴结转移的关系。方法 回顾性分析2010年7月至2013年7月四川省肿瘤医院头颈外科收治的初次手术治疗的248例患者临床及病理资料。结果 肿块位置、最大直径、数量、浸出腺体外膜及受累腺叶数等特征对Ⅵ区和Ⅱ~Ⅴ区淋巴结状态均有影响;低龄与Ⅵ区淋巴结转移有关。肿块位于下极时,Ⅵ区阳转率最高达74.29%,Ⅱ~Ⅴ区仅45.00%,而当肿块位于上极时Ⅵ区为58.33%,Ⅱ~Ⅴ区却高达84.21%。肿块直径>1 cm和2 cm分别为中央区和颈侧区阳转率上升的临界值。结论 肿块位于下极、直径>1 cm、多发、多叶受累、浸出被膜、低龄这些特征可作为中央区淋巴结转移的高危因素;而肿块处于上极、直径>2 cm、多发、多叶受累、浸出被膜等特征可能为颈侧区淋巴结转移的高危因素;应当尤其注意肿块位置与不同区域淋巴结状态的关系以及肿块体积作为区域淋巴结转移的高危因素时其临界值可能不同。

     

    Abstract: Objective To investigate the relationship of tumor location, size, infiltration of thyroid capsule and other clinicopathological features with differentiated thyroid cancer with lymph node metastasis. Methods We retrospectively analyzed clinicopathological data of 248 patients treated with initial surgery in Head and Neck Surgery Department, Sichuan Cancer Hospital from July 2010 to July 2013. Results Tumor location, maximum diameter, quantity, infiltration beyond the outer membrane gland, involved number and other clinicopathologic features were related to level Ⅵ and Ⅱ-Ⅴ lymph node status; Younger age was only related to Ⅵ lymph node metastasis. When the tumor was located in the lower pole, metastasis rates of Ⅵ district was up to 74.29%, and Ⅱ-Ⅴ area were just 45%, while when the tumor was located in the upper pole, metastasis rates of VI district was 58.33%, and Ⅱ-Ⅴ regions were as high as 84.21%. Tumor diameters greater than 1cm and 2cm were the threshold of increased metastasis rates rising in the central and lateral neck districts respectively. Conclusion Mass in the lower pole, diameter >1 cm, multiple, multi-leaf involvement, leaching capsule and younger age could be taken as the risk factors for the central lymph node metastasis; While mass in the upper pole, diameter >2 cm, multiple, multi-leaf involvement and leaching capsule may be the risk factors for the lateral neck lymph node metastasis. We should pay particular attention to the relationship between tumor location and different regions of lymph node status as well as tumor volume critical value may be different when it is the risk factor for regional lymph node metastasis.

     

  • [1] Hay ID, Thompson GB, Grant CS, et al. Papillary thyroid c a r c i n o m a m a n a g e d a t t h e M a y o C l i n i c d u r i n g s i x decades(1940-1999):temporal trends in initial therapy and longterm outcome in 2444 consecutively treated patients[J].World J Surg,2002,26(8):879-85.
    [2] Wada N,Duh QY,Sugino K,et al. Lymph node metastasis from 25 9 papillary thyroid microcarcinomas: frequency, pattern of occurrence and recurrence, and optimal strategy for neck dissection[J]. Ann Surg,2003,237(3):399-407.
    [3] American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, et al. Revised American thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer[J]. Thyroid,2009,19(11):1167-214.
    [4] NCCN.org. NCCN Clinical Practice Guidelines in Oncology[S]. Thyroid carcinoma. Version 1.2012.http://www.nccn.org/ professionals/physician_gls/pdf/thyroid.pdf.
    [5] Patron V, Bedfert C, Le Clech G, et al. Pattern of lateral neck metastases in NO papillary thyroid carcinoma[J].BMC Cancer,2011,11:8.
    [6] Vergez S, Sarini J, Percodani J, et al. Lymph node management in clinically node-negative patients with papillary thyroid carcinoma[J].Eur J Surg Oncol,2010,36(8):777-82.
    [7] Yan DG, Zhang B.cN0 papillary thyroid carcinoma in patients with cervical lymph node processing[J]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi,2012,47(3):257-60.[鄢丹桂,张彬.甲状腺 乳头状癌临床N0患者颈部淋巴结处理[J].中华耳鼻咽喉头颈外 科杂志,2012,47(3):257-60.]
    [8] Wang SY,Zhu ZZ,Peng DF. et al. A clinic study of cervical lymph node matastasis in well-differentiated thyroid carcinoma[J]. Zhonghua Wai Ke Za Zhi, 2008,46(18):1404-6.[王圣应,朱正志, 彭德峰,等.分化型甲状腺癌颈淋巴结转移规律的研究[J].中华 外科杂志,2008,46(18):1404-6.]
    [9] Zhang M,Wei T,Li ZH, et al. Related factors of central lymph node matastasis in papillary thyroid carcinoma[J]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 2012,47(7):565-70.[张明,魏涛,李 志辉,等.甲状腺乳头状癌中央区淋巴转移相关影响因素研究 [J] 中华耳鼻咽喉头颈外科杂志,2012,47(7):565-70.]
    [10] Nixon IJ,Shaha AR. Management of regional nodes in thyroid cancer[J]. Oral Oncol,2013,49(7):671-5.
    [11] Meng C,Gao J,Liang J, et al.Invasive properties of papillary thyroid cancer with concurrent BRAFV600E mutation and rearranged during transfection proto-oncogene protein expression[J]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao, 2013, 35 (1):64-8.[孟超,高洁,梁军,等.甲状腺乳头状癌并BRAFV600E 突变及原癌基因重排蛋白表达与其侵袭性的关系[J].中国医学 科学院学报,2013,35(1):64-8.]
    [12] Zhang YH,Wang GQ. Relationship of autophagy-related gene PTEN and Beclinl in papillary thyroid carcinoma[J]. Lin Chuang He Li Yong Yao Za Zhi, 2011,4(4):34-5.[张艳红,王桂琴.自噬相 关基因PTEN和Beclinl在乳头状甲状腺癌中的表达和意义[J]. 临床合理用药杂志,2011,4(4):34-5.]
    [13] Wang JR, Li XH, Gao XJ,et al.Expression of MMP-13 is associated with invasion and metastasis of papillary thyroid carcin oma[J].Eur Rev Med Pharmacol Sci,2013,17(4):427-35.
    [14] Wu WL,Fan LG,Wang OC, et al. Correlation between the lymph drainage of upperpole and lowerpole of thyroid and the central region lymph node[J]. Zhongguo Xian Dai Yi Sheng,2012,50(14): 12 9-30,132. [吴伟力,范丽妫,王瓯晨,等.甲状腺上下极淋巴引流 与中央区淋巴结相关性研究[J].中国现代医生,2012,50(14):129 -30,132.]
    [15] Shaha AR.Central compartment dissection for papillary thyroid cancer[J].Br J Surg,2013,100(4):438-9.
    [16] Sun RH, Li C, Fan JC, et al. Comparison of recurrence and complication by different thyroidectomy in the treatment of differentiated thyroid carcinoma as initial treatment:A metaanalysis[ J] Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 20 13,48(10):834-9.[孙荣昊,李超,樊晋川,等.不同术式初治分化 型甲状腺癌复发率及并发症比较的Meta分析[J].中华耳鼻咽喉 头颈外科杂志,2013,48(10):834-9.]
    [17] Sun RH, Li C, Fan JC, et al. Meta-analysis of the clinical significance of thyroidectomy combined with central neck dissection in differentiated thyroid carcinoma at the first treatment[J]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi,2014,49(2):157-4.[孙荣昊,李超,樊晋川,等. 中央区淋巴清扫 术对初治分化型甲状腺癌临床价值的Meta分析[J].中华耳鼻咽 喉头颈外科杂志,2014,49(2):157-4.]
计量
  • 文章访问数:  1530
  • HTML全文浏览量:  326
  • PDF下载量:  610
  • 被引次数: 0
出版历程
  • 刊出日期:  2014-09-24

目录

    /

    返回文章
    返回
    x 关闭 永久关闭