甲状腺微小乳头状癌侧颈区淋巴结转移危险因素分析——附2例病例报告

李栋梁; 刘九洋

doi:10.14188/j.1671-8852.2023.0374

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甲状腺微小乳头状癌侧颈区淋巴结转移危险因素分析——附2例病例报告

肿瘤学研究 | 更新时间：2026-11-05

- 甲状腺微小乳头状癌侧颈区淋巴结转移危险因素分析——附2例病例报告
- Risk factors of lateral lymph node metastasis in papillary thyroid carcinoma with two case reports
- 武汉大学学报（医学版） 2025年46卷第3期页码：343-349
- 作者机构：
  
  1.浠水县人民医院胃肠外科湖北黄冈 438299
  2.武汉大学中南医院甲状腺乳腺外科湖北武汉 430071
- 作者简介：
  
  李栋梁，男，1976—，副主任医师，主要从事恶性肿瘤的发病机制研究, E‑mail：lichenglidongliang@163.com
  刘九洋，男，1990—，医学博士，主治医师，主要从事恶性肿瘤侵袭转移的分子机制研究, E‑mail：ahljywhu204@163.com
- 基金信息：
- DOI：10.14188/j.1671-8852.2023.0374
  中图分类号： R736.1
- 收稿：2023-07-03，
  
  纸质出版：2025-03-25
- 稿件说明：
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李栋梁,刘九洋.甲状腺微小乳头状癌侧颈区淋巴结转移危险因素分析——附2例病例报告[J].武汉大学学报（医学版）,2025,46(03):343-349.

LI Dongliang,LIU Jiuyang.Risk factors of lateral lymph node metastasis in papillary thyroid carcinoma with two case reports[J].Medical Journal of Wuhan University,2025,46(03):343-349.
李栋梁,刘九洋.甲状腺微小乳头状癌侧颈区淋巴结转移危险因素分析——附2例病例报告[J].武汉大学学报（医学版）,2025,46(03):343-349. DOI： 10.14188/j.1671-8852.2023.0374.

LI Dongliang,LIU Jiuyang.Risk factors of lateral lymph node metastasis in papillary thyroid carcinoma with two case reports[J].Medical Journal of Wuhan University,2025,46(03):343-349. DOI： 10.14188/j.1671-8852.2023.0374.

摘要

甲状腺乳头状癌发病率逐年升高，其中甲状腺微小乳头状癌占比约50%左右。但是因为甲状腺微小乳头状癌进展慢、预后较好，人们往往忽略了其属于恶性肿瘤的本质。我们在长期的临床实践中发现部分“小肿瘤，大转移”的病例，其发生率为1%~11.2%，相对少见，且早期易漏诊，部分以颈部淋巴结肿大为主要症状就诊。因此，探究甲状腺微小乳头状癌侧颈区转移的风险因素对临床医生判断淋巴结清扫范围、降低患者复发率具有重要意义。一般而言，侧颈部淋巴结转移的风险因素主要包括：性别、年龄、肿瘤大小、肿瘤位置、多灶性、腺外侵袭、组织学亚型、基因突变、中央区淋巴结转移。本文主要通过文献复习，并结合两例甲状腺微小乳头状癌伴颈部淋巴结转移的典型病例，分析潜在风险因素，以提高对此类疾病认识。

Abstract

The incidence of papillary thyroid cancer is increasing year by year

with thyroid micropapillary carcinoma accounting for about 50%. Because papillary thyroid carcinoma progresses slowly and has a better prognosis

its malignant nature is often overlooked. Some cases of "tiny tumor and large metastasis" which occur at a rate of 1% to 11.2%

are relatively rare and easily missed in clinical practice. These cases may also present with palpable lateral lymphadenopathy. Therefore

it is important to explore the risk factors of lateral lymph node metastasis in papillary thyroid carcinoma for clinicians to determine the extent of lymph node dissection and reduce the recurrence rate. Generally

risk factors for lateral lymph node metastasis include gender

age

tumor size

tumor location

multifocality

extrathyroidal extension

histological subtypes

genetic mutations

and central lymph node metastases. In this article

we analyzed potential risk factors to improve understanding of papillary thyroid carcinoma with lateral lymph node metastasis through a literature review and in combination with two typical cases of this disease.

关键词

Keywords

references

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