中央区颈淋巴结清扫在cN0甲状腺乳头状癌的意义

目的探讨中央区颈淋巴结清扫术对oN0甲状腺乳头状癌手术的临床意义。方法回顾性分析56例cN0甲状腺乳头状癌行原发灶根治性切除时行中央区颈淋巴结清扫的资料。结果中央区颈淋巴结阳性率55．36％（31／56），原发灶侵出包膜者、肿瘤直径〉1．0cm中央区颈淋巴结阳性率分别为75．0％（6／8）、65．9％（29／44）。术中1例食管损伤，术后4例出现暂时性喉返神经损伤，5例暂时性低血钙，无出血、永久性喉神经损伤和甲状旁腺功能低下等并发症。术后随访1年～5年，行甲状腺超声、cT、核素扫描检查无复发、转移。结论根治性原发灶切除时清扫中央区颈淋巴结是eN0甲状腺乳头状癌必要而安全术式。

Clinical significance of central lymph node dissection for stage cN0 papillary thyroid cancer

Objective To evaluate the significance of the central compartment neck dissection for cNO papillary thyroid cancer.Methods The clinical data of 56 cases with cNO papillary thyroid cancer in our hospital from Jun 2004 to Jun 2008 were studied.The central compartment lymph node dissection was routinely performed during cNO papillary thyroid cancer operation.Results The lymph node metastasis incidence was55.36%in 56 cNO cases.In patients with extrathyroidal tumor invasion and tumor mass diameter over 1 cm,the lymph node metastasis incidence Was 75.0%and 65.9%,respectively.There Was one case of intraoperative esophagus injury.There were 4 cases of temporary recurrent laryngeal nerve injury and 5 cases of temporary hypoparathyrroidism.There were no complications such as bleeding,permanent laryngeal nerves palsy and permanent hypoparathyroidism.No recurrence and metastasis were found with the thyroid sonography,CT scanning and/or sestamibi scanning examination during a follow-up of 1 to 5 years.Conclusions Central compartment neck dissection is necessary for cNO papillary thyroid cancer.