中国耳鼻咽喉头颈外科2025，Vol.32Issue(11)：688-692,5.DOI:10.16066/j.1672-7002.2025.11.002
老年甲状腺乳头状癌患者颈淋巴结转移的危险因素分析
Analysis of risk factors for cervical lymph node metastasis in elderly patients with papillary thyroid carcinoma
摘要
Abstract
OBJECTIVE To investigate the risk factors of central lymph node metastasis(CLNM)and lateral lymph node metastasis(LLNM)in elderly patients with papillary thyroid carcinoma(PTC).METHODS A retrospective analysis was conducted on clinical data from 330 elderly patients with PTC who underwent thyroidectomy plus cervical lymph node dissection.Univariate and multivariate logistic regression analyses were employed to identify risk factors for CLNM and LLNM.RESULTS All of 330 patients,260(78.79%)were female and 70(21.21%)were male.CLNM was identified in 63 patients(19.09%),while LLNM was found in 21 patients(6.36%).Univariate analysis revealed that age,tumor diameter,bilateral tumors,multifocality,extrathyroidal extension,and NLR≥1.72 were significantly associated with CLNM in elderly PTC patients(P<0.05),while tumor diameter,extrathyroidal extension,NLR,and CLNM showed significant correlations with LLNM(P<0.05).Multivariate analysis demonstrated that tumor diameter>1 cm(OR=2.224,95%CI=1.076-4.597)and extrathyroidal extension(OR=4.751,95%CI=1.703-13.256)were independent risk factors for CLNM in elderly PTC patients(P<0.05).Meanwhile,extrathyroidal extension(OR=7.783,95%CI=1.843-32.876),NLR≥1.72(OR=3.787,95%CI=1.088-13.182),and CLNM(OR=5.751,95%CI=1.845-17.921)were identified as independent risk factors for LLNM(P<0.05).CONCLUSION Tumor size and extrathyroidal extension were risk factors for CLNM in elderly PTC patients,and prophylactic central lymph node dissection should be performed for elderly PTC patients with tumor diameter>1 cm or extrathyroidal extension.Extrathyroidal extension,NLR≥1.72 and CLNM are significant predictors for LLNM,therefore,lateral neck dissection should be considered for elderly PTC patients presenting with these risk factors.关键词
老年/甲状腺肿瘤/甲状腺乳头状癌/淋巴转移/危险因素Key words
Elderly/Thyroid Neoplasms/Thyroid Cancer,Papillary/Lymphatic Metastasis/Risk Factors引用本文复制引用
武元元,陈国利,张建伟..老年甲状腺乳头状癌患者颈淋巴结转移的危险因素分析[J].中国耳鼻咽喉头颈外科,2025,32(11):688-692,5.基金项目
甘肃省省级人才项目(2025QNGR55) （2025QNGR55）
陇原青年创新创业人才项目(甘组通字[2019]39号) （甘组通字[2019]39号）
