摘要
目的:研究术前检查单侧cN0甲状腺乳头状癌(papillary thyroid carcinoma,PTC)病人中央区淋巴结转移的特点及其预防性清扫。方法:回顾性分析我科2016年1月至2018年12月收治的342例行单侧甲状腺腺叶、峡部切除加预防性中央区淋巴结清扫的cN0 PTC病人临床病理资料,分析中央区淋巴结转移的特点。结果:342例中188例(55.0%)出现中央区淋巴结转移。中央区淋巴结转移与年龄(P<0.001)、性别(P<0.001)、肿瘤最大径(P=0.001)、包膜侵犯(P=0.046)、多个中央区淋巴结(P<0.001)相关。中央区转移淋巴结密度与性别(P=0.023)、包膜侵犯(P=0.004)相关。全部病人行预防性中央区淋巴结清扫后,仅发生1例颈部血肿,需再次手术,2例发生暂时性喉返神经麻痹。结论:单侧cN0 PTC病人中央区淋巴结转移有性别、年龄以及淋巴结密度相关特性。因此单侧cN0 PTC病人行预防性中央区淋巴结清扫必要且安全。
Objective To study the central compartment lymph node(CLN)metastasis in patients with unilateral papillary thyroid carcinoma(PTC)diagnosed preoperatively and prophylactic dissection.Methods The data of 342 patients with unilateral PTC at cN0 stage who underwent unilateral thyroidectomy,isthmusectomy and prophylactic CLN dissection were analyzed retrospectively in our department from January 2016 to December 2018.The characteristics of CLN metastasis were analyzed.Results Among 342 patients,188(55.0%)patients had CLN metastasis.CLN metastasis was significantly related with age(P<0.001),sex(P<0.001),maximum diameter of tumor(P=0.001),capsular invasion(P=0.046),and more CLN(P<0.001).Metastatic CLN density is the metastatic CLN%,which was significantly related with sex(P=0.023)and capsular invasion(P=0.004).There was only one case with cervical hematoma and reoperation among all cases in this study.Two cases had temporary recurrent laryngeal nerve paralysis.Conclusions CLN metastasis in unilateral cN0 PTC patients was characterized with relation to sex,age,and lymph node density.Therefore prophylactic CLN dissection is necessary and safe for unilateral cN0 PTC patients.
作者
刘威
王聪
薛安慰
赵骏杰
王正林
LIU Wei;WANG Cong;XUE Anwei;ZHAO Junjie;WANG Zhenglin(Department of General Surgery,Zhongs han Hospital,Fudan University,Shanghai 200032,China)
出处
《外科理论与实践》
2021年第2期159-162,共4页
Journal of Surgery Concepts & Practice
