甲状腺乳头状癌颈Ⅱ区淋巴结转移的临床分析

• 作 者: 吕承洲 董文武 贺亮 张大林 贾爱庆 张浩
• 机 构: 中国医科大学附属第一医院普通外科,
• 出 处: 中国普外基础与临床杂志
• 发表日期: 2015年02期
• 关键词: Ⅱ区淋巴结转移 甲状腺乳头状癌 淋巴结转移率 淋巴结转移 侧区 颈淋巴结清扫术 清扫范围 甲状腺 淋巴结清扫 腺体

目的分析甲状腺乳头状癌(PTC)颈Ⅱ区淋巴结转移的相关因素。方法回顾性分析我科2011年11月至2014年3月期间诊断为甲状腺单叶乳头状癌且仅伴同侧颈侧区淋巴结转移的83例患者的临床资料,将性别、年龄、是否为微小癌、腺体上极受累与否、癌灶包膜是否完整、癌灶外侵与否等情况与颈Ⅱ区淋巴结的转移情况进行分析。计数资料分析采用卡方检验。结果颈部各区的淋巴结转移率分别为Ⅱ区51.8%(43/83)、Ⅲ区78.3%(65/83)、Ⅳ区71.7%(59/83)、Ⅴ区4.8%(4/56)、Ⅵ区79.5%(66/83)。患者性别、年龄、是否为微小癌、包膜是否完整、外侵与否与Ⅱ区淋巴结转移均无关(P>0.05),腺体上极受累与颈Ⅱ区淋巴结转移有关(P<0.05)。结论在PTC患者中,当腺体上极受累时,若决定行颈侧区的择区性淋巴结清扫时则清扫范围应包含Ⅱ区。

Objective To analyze the related factors of cervical lymph node metastasis in papillary thyroid carcinoma (PTC). Methods The clinical data of 83 patients with papillary thyroid carcinoma diagnosed as single thyroid papillary carcinoma and only with ipsilateral cervical lymph node metastasis from November 2011 to March 2014 were retrospectively analyzed. The gender, age and micro-cancer , Whether the gland is very involved or not, the complete or not, the invasion of the foci and the metastasis of cervical lymph nodes. Counting data analysis using chi-square test. Results The rates of lymph node metastasis were 51.8% (43/83) in zone Ⅱ, 78.3% (65/83) in zone Ⅲ, 71.7% (59/83) in zone Ⅳ, 4.8% (4/56) in zone V, Ⅵ area 79.5% (66/83). There was no correlation between gender, age, microencapsulation, complete capsule invasion and invasion or not in lymph node metastasis of stage Ⅱ (P> 0.05). Conclusions In patients with PTC, when the glands are extremely impacted, the dissection area should include zone II if it is decided to perform neck dissection.