摘要
目的 探讨甲状腺癌的颈淋巴结转移规律及选择性颈淋巴结清扫术 ,应用于cN0 甲状腺乳头状癌病例的理论依据和应用原则。方法 前瞻性观察 3 0 0例甲状腺乳头状癌 ,分析cN0 pN+ (病理检查淋巴节阳性 )及cN+ pN+ 病例的颈淋巴结分布规律。结果cN+ pN+ 13 6例 ,cN0 pN+ 164例 ,颈淋巴结转移 2 5 1例 ,占 83 67% ,其中气管周围 2 2 8例 ,同侧Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ区分别为 1例、61例、2 41例、2 46例、5 9例 ;cN0 pN+ 115例 ,分布情况为气管周围 10 8例 ,同侧Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ区分别为 0例、5例、10 5例、10 9例、3例 ;结论甲状腺乳头状癌淋巴结转移最常见于气管周围、颈部同侧Ⅲ、Ⅳ区。选择性颈淋巴结清扫术对cN0 甲状腺乳头状癌具有重要治疗作用。
Objective At present, whether neck dissection should be employed in thyroid papillary carcinoma with clinically node negative neck (cN 0) is still controversial. This study was designed to explore the regularity of cervical lymph node metastasis in thyroid papillary carcinoma, and to discuss the theories and principles of the employment of selective neck dissection in cN 0 cases. Methods A prospective research has been performed on clinical data of 300 cases of thyroid papillary carcinoma treated with surgery from 1996 to 2003.Distribution of cervical lymph node metastasis of cN 0 pN + (pathologically node positive) and cN + (clinically node positive) pN + cases were analyzed.Results Cervical lymph node metastases were found in 251 cases. The metastatic rate was 83.67%. Metastases that occurred in level Ⅰ、Ⅱ、Ⅲ、Ⅳ、Ⅴ of the ipsilateral neck were 0.33%, 20.33%, 80.33%, 82.00%, 19.67% and 76%.Conclusion Level Ⅲ、Ⅳ、of the ipsilateral neck tends to be involved when cervical lymph node metastasis occurs. Selective neck dissection can be used to treat the cervical metastasis in cN 0 cases, as well as to evaluate the cervical lymph node status in order to determine whether comprehensive neck dissection should be employed.
出处
《河南肿瘤学杂志》
2004年第5期336-337,共2页
Henan Journal of Oncology
关键词
甲状腺乳头状癌
颈淋巴结转移规律
选择性颈淋巴结清扫术
neoplasm of thyroid papillary carcinoma
cervical lymph node metastasis
selective neck dissection
