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作 者:邹贤[1] 朱国华[1] 胡本顺[1] 宋智明[1] 孙志强[1] 王丹凤[1]
机构地区:[1]江苏省原子医学研究所附属江原医院普外科,江苏无锡214063
出 处:《中国癌症杂志》2012年第10期770-773,共4页China Oncology
摘 要:背景与目的:甲状腺乳头状癌淋巴转移规律及清扫方法是当前甲状腺外科的研究热点,本研究探讨甲状腺乳头状癌临床颈部淋巴结阴性患者(cN0)发生Ⅵ区淋巴转移的影响因素及临床意义。方法:回顾性分析2011年在江苏省原子医学研究所附属江原医院行全甲状腺切除+颈Ⅵ区淋巴清扫术的305例甲状腺乳头状癌患者临床资料。根据术后病理检查分为淋巴结转移组(134例)和淋巴结未转移组(171例),进行单因素和多因素Logistic回归分析研究。结果:甲状腺乳头状癌淋巴转移率为43.93%,单因素分析发现年龄、双叶癌、包膜侵犯和非微小癌等因素对淋巴结转移的影响差异有统计学意义(P<0.05),多因素分析证实年龄≥45岁、肿瘤侵犯包膜为Ⅵ区淋巴结转移的危险因素。结论:cN0甲状腺乳头状癌有较高的淋巴结转移率,在切除甲状腺的同时清扫颈Ⅵ区的淋巴结是十分必要的。Background and purpose: The way of the lymph node metastases and the method of lymph node dissection of papillary thyroid carcinoma (PTC) are currently the research focus of thyroid surgery. This study was to analyze the risk factors of level VI lymph node involvement for patients with PTC without clinical cervical lymph node metastasis (cN0). Methods: Consecutive 305 cases underwent total thyroidectomy and level VI lymph node dissection from Jan. 2011 to Dec. 2011 were analyzed retrospectively. According to the postoperative pathology results, univariate and multivariate logistic regression analysis were used to analyze risk factors. Results: The central compartment lymph node metastasis rate of PTC patients was 43.93%. Tumor size, age, extra-capsular invasion, and bilateral lesions were significantly corrrelated to lymph node metastasis (P〈0.05). The (cN0) PTC has a high rate of pathological lymph node metastasis, especially in patients with age more than 45 years old, extra-capsular invasion. Conclusion: It is important to conduct the thyroidectomy with ipsilateral level VI lymph node dissection of PTC patients.
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