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目的探讨甲状腺微小乳头状癌(PTMC)冷冻病理特征与中央区淋巴结转移(CLNM)的相关性,为术中合理选择甲状腺癌淋巴结清扫术提供有价值的参考。方法对本院200例甲状腺微小乳头状癌冷冻病理和中央区淋巴结转移情况的病理资料进行回顾性分析。结果单因素分析显示甲状腺微小乳头状癌病灶中心纤维化,病灶存在砂砾体和以乳头状结构为主的中央区淋巴结有更高的转移率(P<0.05),合并桥本甲状腺炎的微小乳头状癌对中央区淋巴结转移率无影响(P>0.05);多因素分析表明,病灶中心纤维化(P<0.05)和乳头结构占优势(P<0.05)是发生中央区淋巴结转移的独立危险因素。结论具有病灶中心纤维化和/或以乳头状结构为主的甲状腺微小乳头状癌伴有更高的中央区淋巴结转移率,术中应清扫中央区淋巴结。
Objective To investigate the correlation between cryopathological features of PTCC and central lymph node metastasis (CLNM), and provide valuable reference for rational selection of lymph node dissection in thyroid cancer during operation. Methods The pathological data of 200 cases of thyroid micropapillary carcinoma and its lymph node metastasis in the central region were analyzed retrospectively. Results Univariate analysis showed central fibrosis in thyroid micropapillary carcinoma lesions. The presence of granitic body in lesions and central lymph nodes with predominant papillary structure had higher metastasis rates (P<0.05). Micropapillary complications with Hashimoto’s thyroiditis were observed. Cancer had no effect on the lymph node metastasis rate in the central region (P>0.05). Multivariate analysis showed that focal fibrosis (P<0.05) and predominance of nipple structure (P<0.05) were independent risk factors for central lymph node metastasis. . Conclusion The thyroid micropapillary carcinoma with central fibrosis and/or papillary structure is associated with a higher rate of central lymph node metastasis. Central lymph nodes should be removed during the operation.