甲状腺乳头状微小癌淋巴结转移相关因素分析

Analysis of lymph node metastasis factors in papillary thyroid microcarcinoma

目的:探讨甲状腺乳头状微小癌颈部淋巴结转移的相关因素,以及一期手术时行择区性淋巴结清扫术的意义。方法:甲状腺乳头状微小癌患者82例中,术中冷冻病理诊断为甲状腺乳头状微小癌者60例(第1组),行择区性颈淋巴结清扫术;术中冷冻病理诊断为甲状腺良性疾病者22例(第2组),未行择区性淋巴结清扫术。结果:行择区性颈淋巴结清扫术60例中,13例(21.67%)出现颈部淋巴结转移;最大直径<0.7cm与≥0.7cm的肿瘤转移率分别为4.76%和30.77%,差异有统计学意义(P<0.05)。所有患者平均随访59.8个月,无复发和死亡,未发现远处转移。结论:甲状腺乳头状微小癌具有一定比例的颈部淋巴结转移率,尤其对于肿瘤最大直径≥0.7cm者行择区性淋巴结清扫术是更有效的治疗方法。

Objective：To analyze the factors of lymph node metastasis in papillary thyroid microcarcinoma and to evaluate the significance of the selective neck dissection. Method： Records of 82 patients with papillary thyroid microcarcinoma were retrospectively analyzed. Sixty patients were received a selective neck dissection （Group 1）, while twenty-two were not （Group 2）. Result： In Group 1,13 patients were found metastasis. The incidence of metastasis was 21. 67% （13/60）. The frequency of nodal metastasis with a carcinomaS0. 7 cm was 4. 76%, while 90.7 cm was 30.77%（ P 〈0.05）. All patients were followed-up from 9 to 14 years（mean 59.8 months）. No patients relapsed or died, and no one was found distant metastasies. Conclusion： The papillary thyroid microcarcinoma had a high tendency to metastasize. It is more significant to perform selective neck dissection in tumors 0.7 cm.