甲状腺乳头状癌中央区淋巴结清扫的临床意义

目的]探讨临床颈淋巴结阴性(CN0)的甲状腺乳头状癌中央区淋巴结清扫的临床意义.方法]对2010年1月至2011年6月收治的178例CN0甲状腺乳头状癌患者行中央区淋巴结清扫,其中67例同期行外侧区淋巴结清扫.评估中央区淋巴结清扫术的安全性,并对中央区及外侧区淋巴结转移相关因素进行分析.结果]中央区淋巴结清扫没有明显增加手术并发症.中央区淋巴结转移率为44.4％；中央区淋巴结转移率与肿瘤大小有关,外侧区淋巴结转移率与中央区淋巴结阳性数目有关.结论]中央区淋巴结清扫是一个方便安全的手术,能使部分患者免除外侧区颈清扫,应列为CN0甲状腺乳头状癌患者的常规选择.

Clinical Significance of Central Neck Lymph Node Dissection in Patients with Papillary Thyroid Carcinoma

Purpose] To investigate the value of central neck lymph node dissection for papillary thyroid carcinoma (PTC) clinically node-negative (CN 0 ). Methods]One hundred seventy-eight cases underwent central neck dissection from January 2010 to June 2011 were enrolled in this study. Ipsilateral neck functional dissection was performed in 67 cases. The safety of central neck dissection was assessed and the related factors of the central and lateral neck lymph node metastasis were analyzed. Results]Central neck dissection did not significantly increase the occurrence of complications,and the incidence rate of central neck lymph nodes metastasis was 44.4% . The metastasis of central neck lymph nodes related to the primary tumor size,while lateral neck lymph metastasis related to the number of positive lymph nodes in central neck. Conclusions] The central lymph node dissection is a convenient and safe operation,which could make some people avoid from the lateral neck dissection. It should be performed as a routine operation in the treatment for CN 0 papillary thyroid carcinoma.