| Objective:Retrospective analysis of the medical history of patients with papillary thyroid carcinoma from January 2015 to May 2017 in Jiangsu Provincial Hospital of Traditional Chinese Medicine.Analysis of cervical lymph node metastases in papillary thyroid carcinomas by univariate analysis and multivariate logistic regression analysis.Using the Life Events Scale(LES Scale)and the Trait Coping Style Scale(TCSQ),a questionnaire survey was conducted on patients with thyroid papillary carcinoma who underwent thyroid surgery in the Department of General Surgery,Jiangsu Provincial Hospital from October 2017 to December 2017.To explore the correlation between emotional factors of TCM and cervical lymph node metastasis in papillary thyroid carcinoma.Methods:From January 2015 to May 2017,219 patients with thyroid papillary carcinoma who underwent thyroid surgery in Department of General Surgery,Jiangsu Provincial Hospital of Traditional Chinese Medicine,94 cases with lymph node metastasis and 125 cases without lymph node metastasis were analyzed with SPSS 23.0 statistical software.Univariate analysis was performed on age,gender,tumor size,number of lesions(single or multifocal),preoperative TSH levels,TGAb levels,and TMAb levels.Univariate analysis of statistically significant variables was included in multivariate binary logistic regression analysis.A clinical study of patients with thyroid papillary carcinoma who underwent thyroid surgery in Department of General Surgery,Jiangsu Provincial Hospital from October 2017 to December 2017,patients was divided into two groups according to postoperative pathology:with lymph node metastasis and no lymph node metastasis.Patients filled in the same questionnaire,life event scale(LES)and Trait Coping Style Scale(TCSQ).The negative life events and the impact of events on the patients and the coping styles of the patients in the two groups were recorded and scored in the past 5 years.SPSS 23.0 statistical software was used for analysis.P<0.05 was considered statistically significant.P<0.001 was highly statistically significant.Results:Of the 219 patients,45 were males,accounting for 20.55%,and 174 were females,accounting for 79.45%.The rates of cervical lymph node metastasis in males and females were 48.89%(22/45)and 41.38%(72/174),respectively.The difference was not statistically significant(P>0.05)219 patients aged 19-80 years old(45.67±12.31),?45 years old,111 cases,>45 years old,108 cases,the rate of cervical lymph node metastasis were 54.95%(61/111),30.56%(33/108),respectively.Highly statistically significant(P<0.001).There were 106 patients with tumor diameter D<lcm,100 patients with lcm?D?3cm,and 13 patients with D>3cm.The rates of cervical lymph node metastasis were 28.30%(30/106),56%(56/100),and 61.54%(8/13),respectively,the difference was highly statistically significant(P<0.001).The number of lesions was 161 in single lesions and 58 in multiple lesions.The rates of cervical lymph node metastases were 40.37%(65/161)and 50%(29/58),respectively,with no statistically significant difference(P=0.204).Preoperative TSH was normal in 189 patients.TSH increased in 21 cases and decreased in 9 cases.The rates of cervical lymph node metastases were 44.44%(84/189),23.81%(5/21),and 55.56%(5/9),respectively.No statistical difference was found(P=0.143).Preoperative TGAb was normal in 123 cases,and TGAb was elevated in 96 cases.The rate of cervical lymph node metastasis was 34.15%(42/123)and 54.17%(52/96),respectively.The difference was statistically significant(P=0.003).Preoperative TMAb was normal in 154 cases,TMAb was elevated in 65 cases,and the rate of cervical lymph node metastasis was 38.31%(59/154)and 53.85%(35/65),respectively.The difference was statistically significant(P=0.034).The age,tumor size,preoperative TGAb and TMAb were included in the multivariate binary logistic regression analysis.The results showed that age and maximum diameter of the tumor were high risk factors of cervical lymph node metastasis in papillary thyroid carcinoma(P<0.05).A total of 69 cases of effective questionnaires were collected,aged 25-63 years,with an average age of 43.06±12.30 years.Among them,15 were males,accounting for 21.74%,and 54 were females,accounting for 78.26%.There were 19 cases with lymph node metastasis and 50 cases without lymph node metastasis.In the lymph node metastasis group,17 cases suffered from various negative life events in the 5 years before the onset,and in the group without lymph node metastasis,14 cases suffered from various negative life events in the 5 years before onset.There were significant differences between the two groups(P<0.001).The mean 5-year LEU score was 65.68±45.92 in the group with lymph node metastasis and 20.30±53.30 in the group without lymph node metastasis.The former was significantly higher than the latter(P<0.001).There was a significant difference in the intensity distribution of negative life events between the two groups(P<0.001).Between the two groups,there were significantly more cases of moderate and severe negative life events in patients with lymph node metastases than in those without lymph node metastases.Patients who had not encountered negative life events were significantly more in the group without lymph node metastasis than those with lymph node metastasis.There was no significant difference in the positive and negative coping styles of negative life events between the two groups(P>0.05).Conclusion:(1)Age,tumor size,preoperative TGAb,TMAb levels were the factors affecting cervical lymph node metastasis in papillary thyroid carcinoma;(2)Age and tumor size were high risk factors of cervical lymph node metastasis in papillary thyroid carcinoma.The risk of young age was higher than that of old age.The larger the tumor diameter,the greater the risk;(3)The frequency of negative life events in the cervical lymph node metastasis group of thyroid papillary carcinoma was significantly higher than that in the group without lymph node metastasis within the first 5 years of diagnosis.Concerns,sadness,anger and other emotional factors and cervical papillary thyroid cancer lymph node metastasis is closely related;(4)The incidence of negative life events in the group with cervical lymph node metastasis of papillary thyroid carcinoma was greater than that in the group without lymph node metastasis.The negative life events were mostly moderate and severe degree of stimulation events. |
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