中央区淋巴结清扫术治疗cN_0甲状腺乳头状癌的价值

The value of central compartment neck lymph node dissection for cN_0 papillary thyroid carcinoma

目的探讨中央区淋巴结清扫术在临床颈淋巴结阴性(cN0)甲状腺乳头状癌治疗中的价值。方法对67例cN0甲状腺乳头状癌行原发灶根治性切除,同时行患侧中央区淋巴结清扫术,清扫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50.7%(34/67)。中央区淋巴结转移与患者的肿瘤直径≤1.0cm或>1.0cm无关(χ2=0.42,P>0.05);与原发灶是否侵犯包膜(χ2=8.76,P<0.01)及年龄<45岁或≥45岁(χ2=4.30,P<0.05)有关。67例均无喉返神经损伤、永久性低钙抽搐等并发症发生。结论cN0甲状腺乳头状癌行中央区淋巴结清扫术是必要的、安全的处理方式。

ObjectiveTo investigate the value of central compartment neck lymph node dissection for papillary thyroid carcinoma of non-metastasis of neck lymph node being discovered（cN0）.MethodsThe clinical data of 67 patients with cN0 papillary thyroid carcinoma from January 2006 to April 2008 were studied.The central compartment neck lymph node dissection was routinely performed during radical thyroidectomy of cN0 papillary thyroid carcinoma,and the specimens were routinely sent for pathological examination.ResultsThe incidence of lymph node metastasis was 50.7% in 67 patients with cN0 papillary thyroid carcinoma.Lymph node metastasis was related with whether or not the thyroid envelope of carcinoma have been invaded（χ2=8.76,P〈0.01） and with age less than,equal or more than 45 years old（χ2=4.30,P〈0.05）,and wasn＇t related with diameter of carcinoma.There were no complications of recurrent laryngeal nerve injury and hypocalcaemia tenancy.ConclusionsIt is necessary and safe to perform central compartment neck lymph node dissection during radical thyroidectomy of cN0 papillary thyroid carcinoma.