1. 中山大学附属第三医院1. 岭南医院普通外科,广东,广州,510000
2. 甲状腺乳腺外科,广东,广州,510630
网络首发:2017-01-20,
纸质出版:2017
移动端阅览
张鹏, 刘瑞磊, 姚志成, 等. 甲状腺乳头状癌淋巴结转移规律及影响因素分析[J]. 中山大学学报(医学科学版), 2017,38(1).
ZHANG Peng, LIU Rui-lei, YAO Zhi-cheng, et al. Metastasis Regulatory of Lymph Node of Papillary Thyroid Cancer and Influence Factors[J]. Journal of Sun Yat-sen University (Medical Sciences), 2017, 38(1).
摘要:【目的】探讨甲状腺乳头状癌的淋巴结转移规律,分析其影响因素。【方法】回顾性分析我院自2011年1月至 2015年12月手术治疗甲状腺乳头状癌病人375 例的临床资料,对其原发灶特点、淋巴结转移规律进行了总结。【结果】本组 患者均为甲状腺乳头状癌,颈部淋巴结总转移率为67.47%,中央组淋巴结转移率为64.27%,颈侧组淋巴结转移率为 36.53%。原发灶肿瘤直径大于1 cm、肿瘤突破包膜、侵犯肌肉时颈淋巴结转移发生率明显升高(P < 0.05)。【结论】甲状腺乳 头状癌最常见的淋巴结转移为中央组淋巴结,初次手术应常规清扫双侧中央组淋巴结,当肿块直径大于1 cm或癌肿突破甲 状腺包膜和/或侵犯肌肉时宜同时清扫同侧的颈侧组淋巴结。
Abstract :【Objective】To explore the metastasis regulatory of lymph node of papillary thyroid cancer and to analyze the influence factors.【Methods】Clinical data of 375 papillary thyroid cancer patients at our hospital between Jun 2011 and Sep 2015 were retrospectively reviewed and summarized the metastasis regulatory of lymph nodes and the tumor characteristics.【Results】All selected patients were diagnosed papillary thyroid cancer. The Total metastasis rate of cervical lymph node was 67.47%,the metastasis rate of region Ⅵ lymph nodes was 64.27%;the metastasis rate of region Ⅱ~Ⅴ lymph nodes was 36.53%. The metastasis rate of lymph nodes of the patients with tumor diameter over 1 cm,breaking through thyroid membrane and invading the cervical muscle were significantly increased(P < 0.05).【Conclusion】The central group lymph nodes were the most metastasis region of papillary thyroid cancer and should routinely be dissected by the first time of surgery. When the tumor diameter greater than 1 cm or cancer breakthrough thyroid membrane and/or invading the cervical muscles,the ipsilateral lateral neck lymph nodes should be dissected at the same time.
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