单侧非微小甲状腺乳头状癌双侧中央区淋巴结清扫的临床意义  

The clinical significance of bilateral central lymph node dissection in unilateral non-minimal papillary thyroid carcinoma

作　　者：张红梅 吴波 刘芮 尹乐平[2] 黄友金[2] ZHANG Hong-mei;WU Bo;LIU Rui;YIN Le-ping;HUANG You-jin(The 4 th Departments of Surgery,Pidu District People's Hospital,Chengdu 611730,China;Department of Thyroid Vascular Surgery,Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu 610072,China)

机构地区：[1]成都市郫都区人民医院外四科,四川成都611730 [2]四川省医学科学院·四川省人民医院甲状腺血管外科,四川成都610072

出　　处：《实用医院临床杂志》2019年第5期129-132,共4页Practical Journal of Clinical Medicine

摘　　要：目的分析单侧非微小甲状腺乳头状癌对侧中央区淋巴结转移的影响因素,探讨单侧甲状腺乳头状癌(uPTC)行双侧中央区淋巴结清扫的临床意义。方法123例行预防性双侧中央区淋巴结清扫术、且原发肿瘤直径>1 cm的患者,分析对侧中央区淋巴结转移的相关因素,同时统计uPTC行双侧中央区淋巴结清扫术后并发症发生率。结果123例患者中,同侧、对侧、双侧中央区淋巴结转移率分别为62.6%、39.8%、36.6%,跳跃转移3.3%,颈侧区转移率43.1%。肿瘤直径、同侧转移、颈侧区转移是对侧转移的独立危险因素。结论对伴有肿瘤直径大于2 cm、患侧中央区转移或颈侧区转移的uPTC患者,应充分考虑对侧转移风险,可考虑行对侧预防性清扫。Objective To investigate the influencing factors of unilateral non-minimal thyroid papillary carcinoma for lymph node metastasis in the central lateral area,and to explore the clinical significance of bilateral central lymph node dissection in thyroid papillary carcinoma.Methods One hundred and twenty-three patients with thyroid papillary carcinoma with diameter>1 cm underwent the preventive bilateral central lymph node dissection.The relative factors of contralateral lymph node metastasis were analyzed.At the same time,the rate of postoperative complications was statistically analyzed.Results In the 123 patients,the lymph node metastasis rates in ipsilateral,contralateral and bilateral central regions were 62.6%,39.8%and 36.6%,respectively.There was 3.3%of skip metastasis and the lymph node metastasis rates inlateral neck area was 43.1%.The results of logistic regression model revealed that tumor size,ipsilateral central regions lymph node metastasis and lateral neck area metastasis were independent predict risk factors of contralateral central regions lymph node metastasis.Conclusion For unilateral papillary thyroid carcinoma with a diameter of>2.0 cm or ipsilateral central regions lymph node metastasis or lateral neck area metastasis,the risk of contralateral metastasis should be fully considered and contralateral central area lymph node dissection is recommended.

关 键 词：非微小甲状腺乳头状癌 对侧中央区淋巴结 中央区淋巴结转移 中央区淋巴结清扫 

分 类 号：R736.1[医药卫生—肿瘤]