摘要
目的探讨甲状腺微小乳头状癌肿瘤部位与颈部淋巴结转移的关系。方法回顾性分析解放军总医院普通外科2013年9月—2015年2月初治的256例甲状腺微小乳头状癌患者临床资料,对肿瘤所在部位与颈部淋巴结转移的关系进行分析。结果甲状腺微小乳头状癌肿瘤部位根据其甲状腺超声结果及手术病程记录分为甲状腺上极(腺体上1/3)、甲状腺中1/3、甲状腺下极(腺体下1/3)、峡部、单侧叶多灶及双侧叶多灶。当肿瘤位于甲状腺腺体中1/3部位时,中央区淋巴结相对转移率(38.6%)较其他部位高(P<0.05)。85例行治疗性侧方淋巴结清扫的患者,肿瘤位于甲状腺腺体中1/3部位时,侧方淋巴结相对转移率(29.2%)较其他部位高(P<0.05);当肿瘤位于甲状腺腺体上极时其患侧方上部淋巴结(相当于Ⅱ区)相对转移率(21.1%)较其他部位高(P<0.05)。结论甲状腺微小乳头状癌肿瘤部位与颈部淋巴结转移率及转移区域有关,当肿瘤位于甲状腺腺体中1/3部位时转移率高于其他部位(P<0.05)。
Objective To discuss the correlation of location of papillary thyroid microcarcinoma with cervical lymph node metastasis. Methods Clinical data about 256 patients from September 2013 to February 2015 in the department of general surgery of Chinese PLA General Hospital were retrospectively analyzed to discuss whether the location of papillary thyroid microcarcinoma correlated with the cervical lymph node metastasis. Results The locations of papillary thyroid microcarcinoma were classified into an upper pole, middle third, lower pole, isthmus, multifocal in affected lobe and multifocal in both lobe based on the results of thyroid ultrasound and operation records. Tumor location in the middle third of thyroid lobe was associated with higher rate of CLNM（central lymph node metastasis）（38.6%, P〈0.05）. In 85 cases underwent therapeutic lateral neck dissection, tumor location in middle third was associated with higher rate of LLNM（lateral lymph node metastasis）（29.2%, P〉0.05）, and location of upper pole was associated with higher rate of ipsilateral upper compartment（referred to levelⅡ） lymph node metastasis（21.1%, P〉0.05）. Conclusion The tumor location of thyroid papillary carcinoma correlates with the rate of lymph node metastasis and lymph node metastatic field, and the rate of lymph node metastasis is higher than other parts when tumor is in the middle-third gland（P〉0.05）.
出处
《解放军医学院学报》
CAS
2016年第6期570-572,610,共4页
Academic Journal of Chinese PLA Medical School
关键词
甲状腺微小乳头状癌
肿瘤部位
颈部淋巴结清扫
淋巴结转移
papillary thyroid microcarcinoma
tumor location
neck lymph node dissection
lymph node metastasis.
