cN0单侧甲状腺乳头状癌中央区各亚区与患侧侧区淋巴结转移关系的探讨被引量：13

Relationship between subgroups of central lymph node metastasis and lateral lymph node metastasis in cN0 unilateral papillary thyroid carcinoma

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摘要目的探讨临床颈部淋巴阴性(cervical lymph node-negative,cN0)的单侧甲状腺乳头状癌(unilateral papillary thyroid carcinoma,uPTC)患侧中央区各亚区淋巴结转移(subgroups of central lymph node metastasis,sCLNM)与患侧侧区淋巴结转移(lateral lymph node metastasis,LNM)间的关系。方法回顾性分析2016年1月至2016年12月于重庆医科大学附属第一医院内分泌乳腺外科行甲状腺全切+中央区淋巴结清扫+患侧侧区淋巴结清扫的161例cN0-uPTC患者的临床病理资料。探讨患侧中央区各亚区淋巴结转移与患侧侧区淋巴结转移之间关系。结果二元logistic回归分析cN0-uPTC患侧中央区各亚区,喉前淋巴结转移、气管前淋巴结转移、患侧气管旁淋巴结转移为患侧侧区淋巴结转移的独立危险因素(P值分别为0.008、0.016、0.035)。喉前淋巴结转移为患侧II区淋巴结转移的独立危险因素(P=0.015)。气管前淋巴结转移为患侧III区淋巴结转移的独立危险因素(P=0.004)。气管前、患侧气管旁淋巴结转移为患侧IV区淋巴结转移的独立危险因素(P值分别为:0.035、0.011)。结论甲状腺癌淋巴结的转移途径有一定规律性,喉前淋巴结转移对患侧II区淋巴结转移有预测价值,气管前淋巴结转移对患侧III区淋巴结转移有预测价值,气管前、患侧气管旁淋巴结转移对患侧IV区淋巴结有预测价值。气管前或患侧气管旁淋巴结转移的cN0-uPTC患者,可考虑行患侧III、IV区淋巴结清扫。在此基础上若同时有喉前淋巴结转移时,可考虑行患侧II、III、IV区淋巴结清扫。 Objective To investigate the relationship between subgroups of central lymph node metastasis(sCLNM)and lateral lymph node metastasis(LNM)of unilatal papillary thyroid carcinoma(uPTC)with cervical lymph node negative(cN0).Methods The clinical and pathological data of 161 patients with cN0-uPTC who underwent total thyroidectomy+central lymph node dissection+lateral lymph node dissection from Jan.2016 to Dec.2016 were retrospectively analyzed.The relationship between the lymph node metastasis of each subarea in the central area of the affected side and the lymph node metastasis of the affected side was investigated.Results Binary logistic regression analysis of cN0-uPTC subregions in the affected central region showed:pre-laryngeal lymph node metastasis,pre-tracheal lymph node metastasis and paratracheal lymph node metastasis were independent risk factors for lymph node metastasis in the affected lateral region(P=0.008,0.016,0.035,respectively).Pre-laryngeal lymph node metastasis was an independent risk factor for lymph node metastasis in the affected area II(P=0.015).Pre-tracheal lymph node metastasis was an independent risk factor for lymph node metastasis in affected area III(P=0.004).Pre-tracheal and para-tracheal lymph node metastasis were independent risk factors for lymph node metastasis in the affected IV area(P=0.035,0.011,respectively).Conclusions The lymph node metastasis pathway of thyroid cancer had certain regularity.The pre-laryngeal lymph node metastasis has the prediction value for the lymph node metastasis of the affected area II.The pre-tracheal lymph node metastasis has the prediction value for the lymph node metastasis of the affected area III.The pre-tracheal and paratracheal lymph node metastasis have the prediction value for lymph node metastasis of the affected area IV.Lymph node dissection in affected areas III and IV needs to be considered in patients with pre-tracheal or paratracheal lymph node metastases.On this basis,lymph node dissection on the affected areas II,III,and IV might be considered if there is pre-laryngeal lymph node metastasis at the same time.

作者周静胡代星苏新良吴凯南曹益嘉任浩宇毛雨何伟 Zhou Jing;Hu Daixing;Su Xinliang;Wu Kainan;Cao Yijia;Ren Haoyu;Mao Yu;He Wei(Department of Breast Center,Chongqing Health Center for Women and Children,Chongqing 401120,China;Department of Thyroid and Breast Surgery,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of General Surgery,People’s Hospital of Changshou,Chongqing 401220,China)

机构地区重庆市妇幼保健院乳腺科重庆医科大学附属第一医院内分泌乳腺外科重庆市长寿区人民医院普外科

出处《中华内分泌外科杂志》 CAS 2019年第1期31-35,共5页 Chinese Journal of Endocrine Surgery

基金重庆市科委研究项目(cstc2017shmsA130066)。

关键词甲状腺肿瘤甲状腺乳头状癌淋巴结转移颈淋巴结清扫术 Thyroid neoplasms Papillary thyroid carcinoma Lymphatic metastasis Neck dissection

分类号 R736.1 [医药卫生—肿瘤]

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参考文献1

1孙荣华,潘先均,苏新良,吕清建,吴凯南.甲状腺乳头状癌颈部淋巴结转移特点及清扫策略[J].中国癌症杂志,2016,26(1):80-87. 被引量：48

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