cN_0甲状腺乳头状癌双侧中央区淋巴结清除临床意义的探讨

Clinical value of two sides central compartment lymph node dissection for cN_0 papilary thyroid carcinoma

目的:探讨双侧中央区淋巴结清除术在临床颈淋巴结阴性(cN0)甲状腺乳头状癌治疗中的意义。方法:对135例cN0甲状腺乳头状癌行原发灶根治性切除,同时行双侧中央区淋巴结清除术,清除标本常规送病理检查。结果:cN0甲状腺乳头状癌患者中央区淋巴结转移率32.6%(44/135)。单侧癌灶同侧中央区淋巴结转移率26.4%(29/110),对侧中央区淋巴结转移率12.7%(14/110),淋巴结的转移与患者的年龄、甲状腺被膜浸润与否和B超示微钙化有关,P<0.05。术后基本未发生喉返神经损伤、永久性低钙血症等并发症。结论:cN0甲状腺乳头状癌行双侧中央区淋巴结清除术是必要的、安全的术式。

OBJECTIVE: To investigate the clinical value of two side central compartment neck lymph node dissection for cN0 papillary thyroid carcinoma.METHODS: The clinical data of 135 patients with cN0 papillary thyroid carcinoma were studied.The central compartment neck lymph node dissection was routinely performed during radical thyroidectomy of cN0 papillary thyroid carcinoma,and the speciments were routinely send for pathological examination.RESULTS: The incidence of lynph node metastasis was 32.6%(44/135).The lymph node metastasis of same side in unilateral thyroid carcinoma was 26.4%(29/110).The lynph node metastasis of either side in unilateral thyroid carcinoma was 12.7%(14/110).Lymph node metastasis was related with age,number of tumor,whether the thyroid envelope of carcinoma have been invaded or not and micro-calcification findings in ultrasound(P<0.05).There were almost no complications of recurrent larvgeal nerve injury and hypocalcaemia.CONCLUSION: It is a safe operative method to perform two side central compartment neck lymph node dissection during radical thyroidectomy of cN0 papillary thyroid carcinoma.