喉鳞状细胞癌中的甲状腺受累——是否应予以保留？
Thyroid Involvement in Laryngeal Squamous Cell Carcinoma-Should it be Spared?
文献信息
| PMID | 42871631 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Francisco J Garratón-Gutiérrez |
| 作者单位 | Department of Otolaryngology Head & Neck Surgery University of Puerto Rico, School of Medicine San Juan Puerto Rico USA. |
| 期刊 | OTO open |
| SCI 分区 | Q2 |
| IF | 1.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 确定接受全喉切除术的西班牙裔喉鳞状细胞癌患者中甲状腺腺体侵犯的患病率和预测因素，并评估甲状腺切除术相关的合并症。
研究设计： 回顾性横断面审查。
地点： 波多黎各圣胡安波多黎各医疗中心大学区医院。
方法： 回顾了2009年至2022年接受全喉切除术的成人喉鳞状细胞癌患者的记录。将肿瘤特征与组织病理学甲状腺腺体侵犯进行相关性分析，并记录术后低钙血症。分类变量采用Fisher精确检验或Pearson卡方检验进行比较，效应量以Cramér's V报告；连续变量采用Wilcoxon-Mann-Whitney检验进行分析。
结果： 在105例患者中，8例（7.6%）存在甲状腺腺体侵犯。有侵犯的肿瘤更大（5.0±1.3 vs 3.3±1.4 cm；P=.003），并与甲状软骨侵犯相关（100% vs 54.6%；P=.020）。有侵犯的患者更常接受全甲状腺切除术（75.0% vs 28.9%；P=.013）。术后低钙血症总体发生于41.9%（44/105）的患者，并且在全甲状腺切除术后比部分甲状腺切除术后更常见（79.4% vs 23.9%；P<.001）。19.0%（20/105）的患者需要静脉补钙，全甲状腺切除术后更常需要（47.1% vs 5.6%；P<.001）。
结论： 甲状腺腺体侵犯不常见，但与更大的肿瘤和甲状软骨侵犯相关。全甲状腺切除术带来更高的低钙血症风险和更严重的程度。这些发现支持在全喉切除术中进行选择性甲状腺管理，并提供了来自代表性不足的西班牙裔人群的证据。
英文摘要
OBJECTIVES: To determine the prevalence and predictors of thyroid gland invasion in Hispanic patients with laryngeal squamous cell carcinoma undergoing total laryngectomy and to assess thyroidectomy-associated comorbidities.
STUDY DESIGN: Retrospective cross-sectional review.
SETTING: University District Hospital, Puerto Rico Medical Center, San Juan, PR.
METHODS: Records of adults with laryngeal squamous cell carcinoma who underwent total laryngectomy from 2009 to 2022 were reviewed. Tumor characteristics were correlated with histopathologic thyroid gland invasion, and postoperative hypocalcemia was documented. Categorical variables were compared using Fisher's exact or Pearson's chi-square tests, with effect size reported by Cramér's V; continuous variables were analyzed with the Wilcoxon-Mann-Whitney test.
RESULTS: Of 105 patients, 8 (7.6%) had thyroid gland invasion. Tumors with invasion were larger (5.0 ± 1.3 vs 3.3 ± 1.4 cm; P = .003) and were associated with thyroid cartilage invasion (100% vs 54.6%; P = .020). Patients with invasion underwent total thyroidectomy more often (75.0% vs 28.9%; P = .013). Postoperative hypocalcemia occurred in 41.9% (44/105) of patients overall and was more frequent after total than after partial thyroidectomy (79.4% vs 23.9%; P < .001). Intravenous calcium replacement was required in 19.0% (20/105) of patients, more often after total thyroidectomy (47.1% vs 5.6%; P < .001).
CONCLUSION: Thyroid gland invasion was uncommon but associated with larger tumors and thyroid cartilage invasion. Total thyroidectomy carried a higher risk and greater severity of hypocalcemia. These findings support selective thyroid management during total laryngectomy and provide evidence from an underrepresented Hispanic population.