甲状腺乳头状癌合并桥本氏甲状腺炎右侧喉返神经深层淋巴结转移情况分析

目的:探讨甲状腺乳头状癌(PTC)合并桥本氏甲状腺炎(HT)患者右侧喉返神经深层淋巴结(LN-prRLN)的转移情况.方法:选取本院2015年7月至2019年12月收治的123例PTC合并HT及150例单纯PTC病例为研究对象,分为观察组、对照组.所有患者均行中央区淋巴结完整清扫,比较2组颈部中央区淋巴结转移情况,分析...

Analysis of metastasis of lymph node posterior to right recurrent laryngeal nerve in patients with papillary thyroid carcinoma and Hashimoto's thyroiditis

Objective To analyze the metastasis of lymph node posterior to right recurrent laryngeal nerve（ LN-prRLN）in patients with papillary thyroid carcinoma （PTC） and Hashimoto's thyroiditis （HT）. Methods 123 patients withPTC and HT and 150 patients with PTC from July 2015 to December 2019 were enrolled the in study as observationgroup and control group respectively. All cases underwent complete dissection of lymph node， and the metastasisof central compartment lymph node was compared between two groups. The incidence of LN-prRLN metastasis wascompared among different patients with clinicopathological features， and multivariate logistic regression analysis wasperformed to explore the independent risk factors of LN-prRLN m etastasis in observation group. Results Postoperativepathological results showed that the incidence of central compartment lymph node metastasis， total incidence of LNprRLNmetastasis， and incidence of alone metastasis of LN-prRLN in observation group and control group were 43.1%and 48.0%， 26.8% and 30.0%， 4.9% and 9.3%， respectively. And there were no statistically significant differencesbetween two groups. Single factor analysis result showed that incidence of LN-prRLN metastasis in patients withtumor maximum diameter > 2.0 cm， tumor number ≥ 2， tumor located in the low part of parathyroid gland， thyroidcapsule invasion， peripheral tissue invasion， the dissection number of central compartment lymph node ≥ 5 pieces，combined with significantly increased central compartment lymph node metastasis and lateral lymph node metastasesin observation group. Multivariate logistic regression analysis showed that tumor number ≥ 2 and thyroid capsuleinvasion were the independent risk factors for patients with LN-prRLN metastases in observation group（ OR=1.986，3.338）. Conclusion LN-prRLN metastases occur in a quarter of patients with PTC and HT， so LN-prRLN shouldbe routinely explored during dissection of central compartment lymph node， and those patients with tumor number≥ 2 and thyroid capsule invasion are recommended tocomplete dissection of LN-prRLN.