南京医科大学学报（自然科学版）2026，Vol.46Issue(8)：1137-1144,8.DOI:10.7655/NYDXBNSN260309
基于不同肿瘤位置分型的甲状腺乳头状癌Ⅱ、Ⅳ区淋巴结转移危险因素分析
Risk factors for level Ⅱ and level Ⅳ lymph node metastasis in papillary thyroid carcinoma based on different tumor location classifications
摘要
Abstract
Objective:To identify risk factors for level Ⅱ and level Ⅳ lymph node metastasis in papillary thyroid carcinoma(PTC)and to evaluate the predictive value of different tumor location classification methods.Methods:A retrospective analysis was performed on PTC patients who underwent thyroid surgery between January 2022 and May 2025.Clinical and pathological variables were collected.Tumor location was classified using the conventional longitudinal trisection method and a middle thyroid vein-based method on preoperative contrast-enhanced CT images.Univariate and multivariate logistic regression were used to analyze factors related to level Ⅱ and Ⅳ lymph node metastasis,and ROC curves were used to compare the predictive ability of different tumor location classifications.Results:Among 152 patients,59(38.82％)had level Ⅱ lymph node metastasis and 113(73.34％)had level Ⅳ lymph node metastasis.Univariate analysis revealed that tumor location was significantly associated with metastasis in both levels(P＜0.05).Multivariate analysis showed tumor location(conventional or middle vein-based)independently predicted level Ⅱ metastasis,while middle vein-based location and level Ⅵ metastasis independently predicted level Ⅳ metastasis.ROC analysis showed that the middle vein-based classification had a higher AUC for predicting level Ⅱ metastasis than the traditional method(0.749 vs.0.608,P＜0.05).For level Ⅳ,the AUCs were 0.687 and 0.650.This indicates better performance for predicting level Ⅱ metastasis.Conclusion:Tumor location is closely associated with level Ⅱ and level Ⅳ lymph node metastasis in PTC.The middle thyroid vein-based classification may improve preoperative risk assessment of lateral cervical lymph node metastasis.关键词
甲状腺乳头状癌/肿瘤位置分型/中静脉/侧颈区淋巴结转移Key words
papillary thyroid carcinoma/tumor location classification/middle thyroid vein/lateral cervical lymph node metastasis分类
医药卫生引用本文复制引用
冯勤超,朱国华,任冬冬,王国瑞..基于不同肿瘤位置分型的甲状腺乳头状癌Ⅱ、Ⅳ区淋巴结转移危险因素分析[J].南京医科大学学报（自然科学版）,2026,46(8):1137-1144,8.基金项目
江苏省医学重点学科(实验室)基金(ZDXYS202211) （实验室）
