颈中线淋巴结阳性率在甲状腺乳头状癌患者淋巴结不同清扫术式中的预估价值  

Clinical study and significance of midline cervical lymph node in surgical decision of papillary thyroid carcinoma

作　　者：李汉君[1] 陈涛[1] 王婧洁[1] 地里呼玛尔·吐鲁洪 曾慧娟[1] 王璐璐 王少华[1] LI Han-jun;CHEN Tao;WANG Jing-jie;Dilihumaer Tuluhong;ZENG Hui-juan;WANG Lu-lu;WANG Shao-hua(Department of General surgery,Jinling Hospital,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)

机构地区：[1]东部战区总医院(原南京军区南京总医院)全军普通外科研究所,南京210002

出　　处：《医学研究生学报》2021年第8期850-852,共3页Journal of Medical Postgraduates

摘　　要：目的目前颈中线淋巴结(Mid-CLNs)转移对甲状腺乳头状癌(PTC)患者双侧淋巴结清扫术式的选择存在分歧。文中旨在探讨Mid-CLNs阳性率在PTC患者淋巴结不同清扫术式中的预估价值。方法回顾性分析2017年10月至2019年8月因甲状腺癌就诊于东部战区总医院普通外科185例行甲状腺切除术的患者临床资料。统计分析Mid-CLNs与对侧VI区淋巴结(Cont-CLNs)的关系,评估Mid-CLNs阳性率对Cont-CLNs转移的预测效能。结果185例患者中共有123例患者发生颈部淋巴结转移(66.49%),其中有93例患者发生Mid-CLNs转移(75.61%)。Mid-CLNs与Cont-CLNs转移相关(P<0.05)。Mid-CLNs阳性率对Cont-CLNs转移预测的AUC为0.802,最佳界值为0.495,敏感度为0.674,特异度为0.820,Cut-off为38%。结论Mid-CLNs阳性率对PTC患者的对侧淋巴结清扫有一定预测价值。Objective At present,there are still some differences in the surgical methods for papillary thyroid carcinoma.The purpose of this study was to investigate the role of midline cervical lymph nodes(Mid-CLNs)in the formulation of surgical procedures for patients with papillary thyroid carcinoma.Methods It was retrospectively analyzed clinical data of 185 patients who underwent thyroidectomy in the breast surgery department of the General Hospital of the Eastern Theater Command from October 2017 to August 2019 for thyroid cancer.The relationship between sex,age,tumor size,thyroglobulin,Hashimoto's thyroiditis,bilateral VI lymph nodes(Cont-CLNs)and Mid-CLNs metastasis was statistically analyzed.The ROC curve was drawn to evaluate the predictive efficacy of the positive rate of Mid-CLNs in contralateral VI lymph node(Cont-CLNs)metastasis.Results A total of 123(66.49%)of the 185 patients developed cervical lymph node metastasis,among which 93 patients(75.61%)developed Mid-CLNs metastasis.Age,tumor size,lymph node metastasis and Cont-CLNs metastasis of the affected side were closely related to the metastasis of Mid-CLNs(P<0.05).ROC curve analysis results show that the AUC of Mid-CLNs positive rate for Cont-CLNs metastasis prediction is 0.802,the best bound value is 0.495,the sensitivity is 0.674,the specificity is 0.820,and the Cut-off is 38%.Conclusion Mid-CLNs metastasis is closely related to Cont-CLNs metastasis.When the positive percentage of Mid-CLNs was 38%,the diagnostic value of Cont-CLNs metastasis was the highest.

关 键 词：甲状腺乳头状癌 颈中线淋巴结 对侧VI区淋巴结 

分 类 号：R736.1[医药卫生—肿瘤]