摘要
目的分析甲状腺乳头状癌颈后三角（V区）淋巴结隐匿转移的发生情况。方法回顾性分析中国医学科学院肿瘤医院头颈外科475例V区临床阴性的初治甲状腺乳头状癌患者的临床资料，统计其中275例临床颈部淋巴结阳性（cN＋）患者颈清扫标本的病理资料，并按甲状腺乳头状癌危险度分为高危组（83例）、中危组（104例）和低危组（88例），分析V区淋巴结转移情况；另对200例临床无淋巴结转移（oN0）患者进行随访，记录其颈部复发情况。结果275例cN＋患者的V区淋巴结隐匿转移率为17．5％，其中低、中、高危组分别为9．1％、19．2％和24．1％，（P〈0．05）。按颈静脉链淋巴结（Ⅱ～Ⅳ区）阳性数目分为1枚、2～10枚和〉10枚组，其V区隐匿转移率分别为0、4．5％和24．6％。结论甲状腺乳头状癌颈转移的患者如临床未发现V区有肿大淋巴结，需结合患者情况慎重决定是否清扫V区，低危患者和其他区域淋巴结转移较少者可考虑密切观察。
Objective To analyze the occurrence and frequency of level V occult metastasis of papillary thyroid carcinoma. Methods The clinlcopathological data of 475 patients in our hospital from 1980 to 1996 were retrospectively analyzed. Pathological results of 275 cN ＋ patients were analyzed and 200 cases with no lymph node metastasis were followed up to compare the recurrence rate of those two groups. The 275 cN ＋ patients were divided into 3 subgroups according to the risk levels： high risk group 83 cases, moderate risk group 104 cases and low risk group 88 cases. Results The occurrence rate of level V node occult metastasis in the 275 cases was 17.5% , among them, the results of low risk, moderate and high risk groups were 9. 1% , 19.2% and 24. 1% , respectively （Chi-Square value 7. 041, P 〈 0.05）. These 3 groups were divided according to the number of level Ⅱ -Ⅳ positive lymph nodes 1 , 2-10 and more than 10, and the rate was 0, 4.5% and 24.6% , respectively. Conclusion Careful prudence is needed to decide whether a patient of papillary thyroid carcinoma with clinically negative level V node nletastasis should be operated for level V lymph node dissection or not. Patients of low risk group or with less positive lymph nodes could be kept under observation for level V node metastasis.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2010年第4期313-315,共3页
Chinese Journal of Oncology
