摘要
目的:分析甲状腺乳头状癌的临床病理特点及其中央区淋巴结转移情况;评估全甲状腺切除+预防性患侧中央区淋巴结清扫术的手术有效性和安全性。方法:回顾性分析2012年6月-2015年6月在我中心经手术和病理证实的483例甲状腺乳头状癌患者的病历资料,所有患者均行全甲状腺切除+患侧中央区淋巴结清扫术。结果:483例甲状腺乳头状癌中,术后病理证实对侧微小癌32例(6.63%)。证实患侧中央区淋巴结转移163例(33.75%)。单侧多发癌灶中央区淋巴结转移率明显高于单侧单发病灶(分别为49.24%、30.72%),差异有统计学意义(χ2=13.877,P<0.05)。单发病灶中,微小癌和直径大于1 cm的乳头状癌在中央区淋巴结转移率上比较差异没有统计学意义(χ2=0.966,P>0.05)。多发病灶中,微小癌和合并有微小癌的患者中央区淋巴结转移率明显高于癌灶直径均大于1cm的病例,全为微小癌的病例中央区淋巴结转移率高于合并有微小癌的病例,差异有统计学意义(χ2=7.066,P<0.05)。暂时性低钙血症发生率13.87%;永久性甲状旁腺损伤发生率0.62%;短暂性饮水呛咳发生率3.73%,无永久性饮水呛咳的病例。喉返神经短暂性麻痹发生率3.11%。结论:甲状腺乳头状癌易早期出现中央区淋巴结转移;全甲状腺切除+预防性患侧中央区淋巴结清扫术手术安全有效。
Objective To analyze the clinical pathological features and the central lymph node metastasis of papillary thyroid carcinoma. To assess the safety and effectiveness of total thyroidectomy plus prophylactic ipsilateral central lymph node dissection in the treatment of papillary thyroid carcinoma. Methods A retrospective analysis of the clinical data 483 cases of papillary thyroid carcinomas operated from June 2012 to June 2015 in thyroid surgery of our treatment center after confirmed by surgery and pathology of papillary thyroid carcinoma. Results Among 483 cases of papillary thyroid carcinoma,32 cases（6.63%） were confirmed by pathology after operation. Whilst 163 cases（33.75%） were identified as the ipsilateral central lymph node metastasis. Unilateral multiple tumor lymph node metastasis rate was significantly higher than that in the unilateral solitary lesions（49.24%,30.72%）,the difference has statistical significance（χ^2= 13.877,P〈0.05）. Single lesion,microcarcinoma and diameter greater than 1 cm papillary carcinoma in lymph node metastasis rate compared the difference was not statistically significant（χ^2= 0.966,P〉0.05）. Multiple lesions,microcarcinoma and merge with tiny cancer patients with lymph node metastasis rate was significantly higher than that in the cases of tumor diameter was larger than 1 cm,full of tiny cancer cases of lymph node metastasis was higher than that with small cancer cases,the difference has statistical significance（χ^2= 7.066,P〈0.05）.Temporary hypocalcemia incidence rate is 13.87%.The incidence of permanent parathyroid injury was 0.62%. The incidence of transient drinking water was 3.73%,no permanent water choke cough cases. Recurrent laryngeal nerve palsy was 3.11%. Conclusion Papillary thyroid carcinoma is easy to occur in the early stage of central lymph node metastasis. Total thyroidectomy ＋ preventive ipsilateral central lymph node dissection surgery is safe and effective.
出处
《湖北医药学院学报》
CAS
2017年第1期56-59,63,共5页
Journal of Hubei University of Medicine
关键词
甲状腺肿瘤
甲状腺乳头状癌
淋巴结清扫
治疗
Thyroid Neoplasms
Papillary thyroid carcinoma
Lymph node dissection
Therapy
