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首页> 外文期刊>Bulletin du Cancer: Journal de l'Association Francaise pour l'Etude du Cancer >Identification of risk factors of central lymph node metastasis and evaluation of the effect of prophylactic central neck dissection on migration of staging and risk stratification in patients with clinically node-negative papillary thyroid microcarcinoma
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Identification of risk factors of central lymph node metastasis and evaluation of the effect of prophylactic central neck dissection on migration of staging and risk stratification in patients with clinically node-negative papillary thyroid microcarcinoma

机译：中枢性淋巴结转移危险因素的鉴定及预防核心缺陷对临床节点阴性乳头状微癌患者分期和风险分层迁移效果的评价

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Summary Objective The first aim of this study was to explore the risk factors that were associated with central lymph node metastasis (CLNM) in patients with clinically node-negative papillary thyroid microcarcinoma (cN 0 PTMC) after prophylactic central neck dissection (PCND). The second aim was to evaluate the influence of PCND on migration of TNM staging and risk stratification (RS) in patients with cN 0 PTMC. Methods A total of 295 cN 0 PTMC patients who underwent thyroidectomy with PCND in the Department of General Surgery at Guangdong General Hospital between March 2014 to December 2015 were assessed retrospectively. The relations of CLNM with clinicopathologic characteristics of cN 0 PTMC were analyzed by univariate and multivariate logistic regression. The effect of PCND on migration of TNM staging and RS was also observed. Results The incidence of CLNM was 42.4% (125 of 295 cases) in patients with cN 0 PTMC. Univariate analysis showed that age ( P = 0.000), ultrasonographic tumor size ( P = 0.009), pathologic tumor size ( P = 0.005), and multifocality ( P = 0.031) were significantly associated with the incidence of CLNM. No significant correlations were found between the presence of CLNM and other variables such as gender ( P = 0.399), bilaterality ( P = 0.118), capsular invasion ( P = 0.111), lymphovascular invasion ( P = 0.184), extent of thyroidectomy ( P = 0.319) and lymphadenectomy ( P = 0.458). Multivariate logistic regression analysis revealed that age 45 years ( P = 0.000) and multifocality ( P = 0.033) were independent predictors of CLNM in patients with cN 0 PTMC. Because of the identification of CLNM in the implementation of PCND, 42 (14.2%) patients were upstaged, and 118 (40.0%) patients upgraded in RS. Conclusions CLNM is highly prevalent in cN 0 PTMC. Age 45 years and multifocality are independent risk factors of CLNM in cN 0 PTMC patients. PCND can identify CLNM, which allows more accurate TNM staging/RS and may have an important impact on postoperative treatment in cN 0 PTMC patients.
机译：发明内容本研究的第一个目的是探讨预防性中央颈部解剖（PCND）后患有临床节点阴性乳头状乳头状微癌（CN 0 PTMC）的患者中央淋巴结转移（CLNM）的危险因素。第二个目的是评估PCND对CN 0 PTMC患者TNM分期和风险分层（RS）迁移的影响。方法评估2014年3月至2015年12月在2015年3月至2015年12月在2015年3月至2015年12月在2015年12月间接受过甲状腺切除术治疗甲状腺切除术的甲状腺切除术患者。通过单变量和多变量逻辑回归分析ClnM与CN 0 PTMC临床病理特征的关系。还观察到PCND对TNM分期和rs迁移的影响。结果CN 0 PTMC患者，CLNM的发病率为42.4％（125例295例）。单变量分析表明，年龄（p = 0.000），超声肿瘤大小（p = 0.009），病理肿瘤大小（p = 0.005）和多致（p = 0.031）与Clnm的发生率显着相关。在ClnM和其他变量的存在下没有发现显着的相关性（例如性别（p = 0.399），双侧（p = 0.118），荚膜侵袭（p = 0.111），淋巴血管侵袭（p = 0.184），甲状腺切除术的程度（p = 0.319）和淋巴结切除术（P = 0.458）。多变量逻辑回归分析显示年龄＆ 45年（P = 0.000）和多焦度（P = 0.033）是CN 0 PTMC患者的CLNM的独立预测因子。由于在PCND的实施中鉴定CLNM，42例（14.2％）患者被勘探，118例（40.0％）患者以卢比升级。结论CN 0 PTMC中的CLNM高度普遍。年龄＆ 45岁和多焦点是CN 0 PTMC患者中CLNM的独立风险因素。 PCND可以识别CLNM，其允许更准确的TNM暂存/ RS，并且可能对CN 0 PTMC患者的术后治疗产生重要影响。

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