甲状腺乳头状癌颈Ⅱ区淋巴结转移的临床分析  

Relevant Factors Analysis of Level Ⅱ Lymphatic Metastasis in Papillary Thyroid Carcinoma

作　　者：吕承洲[1] 董文武[1] 贺亮[1] 张大林[1] 贾爱庆[1] 张浩[1] 

机构地区：[1]中国医科大学附属第一医院普通外科,辽宁沈阳110001

出　　处：《中国普外基础与临床杂志》2015年第2期177-180,共4页Chinese Journal of Bases and Clinics In General Surgery

基　　金：辽宁省"百千万人才工程"资助项目(编号:2014921033);高等学校博士点专项科研基金项目(编号:20122104110006);辽宁省科学技术计划项目(编号:2012225087);辽宁省博士科研启动基金计划资助项目(编号:20141042)~~

摘　　要：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 relevant factors of level Ⅱ lymph node metastasis in papillary thyroid carcinoma. Methods The clinicopathologic data of 83 patients from November 2011 to March 2014 were analyzed retrospectively. All the primary tumors were papillary thyroid carcinoma located in unilateral lobe with ipsilateral lateral neck lymph node metastasis. The relationship of gender, age, microcarcinoma, superior pole involved by carcinoma, integrated tumor capsule, or extranodal invasion to level Ⅱ lymph node metastasis was analyzed. The calculated data were analyzed with Chi-Square test and there was significant difference when P〈0.05. Results The rate of lymph node metastasis at level Ⅱ, Ⅲ, Ⅳ, Ⅴ, Ⅵ was 51.8%（43/83）, 78.3%（65/83）, 71.7%（59/83）, 4.8%（4/56）, and 79.5%（66/83）, respectively. There was no significant relationship of gender, age, microcarcinoma, integrated tumor capsule, or extranodal invasion to level Ⅱ lymph node metastasis（P〉0.05）. The rate of lymph node metastasis at level Ⅱ was significantly higher when superior pole involved by carcinoma（P〈0.05）. Conclusion Among the patients with papillary thyroid carcinoma, when superior pole involved by carcinoma the patient should be underwent selective neck dissection, the proper extent of dissection including level Ⅱ should be performed.

关 键 词：甲状腺乳头状癌 淋巴结转移 颈淋巴结清扫术 

分 类 号：R736.1[医药卫生—肿瘤]