摘要
甲状腺乳头状癌容易发生颈部淋巴结转移,侧颈部是常见受累部位之一。颈部清扫术是治疗甲状腺癌颈转移的标准手段,但其清扫范围存在争议,应视颈部淋巴结转移的不同区域而定。广泛的侧颈部转移,建议治疗性的改良根治性颈清扫;颈部淋巴结转移不广泛者,特别是术前影像学检查或查体未发现ⅡB区和ⅤA区转移者,建议行ⅡA、Ⅲ、Ⅳ、ⅤB区的择区性颈清扫;c N0患者不主张行预防性颈清扫术。建议同时采用c N分期和p N分期来区别对待颈部淋巴结。
Papillary thyroid cancer is prone to cervical lymph node metastasis. One of the regions that are commonly involved is lateral neck compartment. The standard procedure for oncologie treatment of cervical metastases is neck dissection. However, the extent of neck dissection is con- troversial with the different levels of cervical lymph node involvement. Therapeutic modified radi- cal neck dissection is recommended for cases of gross node metastasis ,while selective neck dissec- tion including level Ⅱ A,Ⅲ, Ⅳ, and V B is recommended for those without evidence of involve- ment in level ⅡB and level Ⅴ A by preoperative imaging or clinical evaluation. Prophylactic neck dissection is not recommended for lymph node-negative patients. To distinguish different status of neck lymph nodes, combined utilization of clinical and pathologic nodal staging is proposed.
出处
《中国肿瘤》
CAS
2015年第6期448-451,共4页
China Cancer
关键词
甲状腺乳头状癌
侧颈部
淋巴结清扫
papillary thyroid cancer
lateral neck compartment
neck dissection
