cN1b甲状腺乳头状癌V区淋巴结转移特点及相关因素探索 |
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引用本文: | 刘木元,彭汉伟,郭海鹏,杨熙鸿.cN1b甲状腺乳头状癌V区淋巴结转移特点及相关因素探索[J].内分泌外科杂志,2012,6(1):24-27. |
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作者姓名: | 刘木元 彭汉伟 郭海鹏 杨熙鸿 |
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作者单位: | 515000,汕头大学医学院附属肿瘤医院头颈科 |
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摘 要: | 目的探讨cNlb甲状腺乳头状癌V区淋巴结转移特点及其预测因素。方法回顾性分析2005年6月至2010年6月汕头大学医学院附属肿瘤医院接受治疗性颈清扫(Ⅱ~V区)的cNlb且V区临床阴性的甲状腺乳头状癌93例的临床资料,颈清扫淋巴结标本按颈部分区收集并送术后常规病理检查。结果93例中,Ⅱ、Ⅲ、Ⅳ及V区淋巴结转移率分别为58.1%(54/93)、68.8%(64/93)、73.1%(68/93)和16.1%(15/93),多因素分析显示Ⅱ~V区同时转移与否是影响V区淋巴结转移的危险因素(32.3%VS7.3%,OR=4.3,P=0.027)。结论术中冰冻切片或术前CT评价Ⅱ~Ⅳ区非同时阳性时,cN1b且V区临床阴性甲状腺乳头状癌患者无需常规行V区清扫。
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关 键 词: | 甲状腺乳头状癌 淋巴转移 颈淋巴结清扫术 |
Level V lymph node metastasis in patients with cN1b papillary thyroid carcinoma |
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Authors: | LIU Mu-yuan PENG Han-wei GUO Hai-peng YANG Xi-hong |
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Institution: | . Departraent of Head and Neck Surgery, Cancer Hospital, Shantou University, Shantou 515000, China |
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Abstract: | Objective To evaluate the frequency and pattern of level V lymph nodes (LNs)metastasis and to identify the risk factors for level V LNs in papillary thyroid carcinoma (PTC)patients with positive lateral neck LNs. Methods 93 cases with PTC undergoing therapeutic lateral neck dissection (level Ⅱ-Ⅴ) from Jun. 2005 to Jun. 2010 were retrospectively reviewed. Neck dissection specimens were obtained for histological analysis of LNs metastasis. Results LNs metastasis rate was 58.1% (54/93) , 68.8% (64/93), 73.1% (68/93) and 16.1% (15/93) respectively in level Ⅱ , Ⅲ, Ⅳ and Ⅴ. Occult metastasis in level V was observed in 15 (16.1%) patients. Multivariate analysis showed lymphatic metastasis with or without simultaneous multilevel involvement (level Ⅱ , Ⅲ, and Ⅳ) was associated with level Ⅴ metastasis (32.3% vs 7.3%, OR =4.3, P = 0. 027 ). Conclusions Level V lymph nodes dissection can be omitted in the treatment of PTC patients if simultaneous multilevel involvement ( level Ⅱ , Ⅲ, and Ⅳ) of lymphatic metastasis is not found by histological examination or CT scan. |
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Keywords: | Papillary thyroid carcinoma Lymphatic metastasis Neck dissection |
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