分化型甲状腺癌颈淋巴结转移的规律

The pattern of cervical lymph node metastases in differentiated thyroid carcinoma

目的：寻求分化型甲状腺癌颈淋巴结转移的规律。方法：本文通过对１９８１～１９９０年间行颈淋巴结清除术的分化型（乳头状、滤泡状）甲状腺癌３１４例进行分析。治疗性组１３６例，选择性组１７８例（均为包膜外型及腺外型）。结果：选择性组淋巴转移率为６８％（１２１／１７８），其中气管旁淋巴结阳性，颈内静脉周围淋巴结阴性４例，气管旁淋巴结阴性而颈内静脉周围淋巴结阳性者有９８例，这些病例中转移淋巴结位于颈上、中者占９１８％（９０／９８）。结论：位于甲状软骨旁者多发生上颈淋巴结转移，位于环状软骨旁者多发生中颈淋巴结转移。

We have analyzed a group of 314 patients with differentiated thyroid cancer who were undergone cerviai dissection between 1981 to 1990. Of the 314 patients, 136 had performed therapeutic cervical dissection and 178 performed selective dissection (both primary tumors had invaded intrathyroid and extrathyroid). In the group of seiective neck dissection, the rate of regional nodes metastases was 68%(121/178). Of the patients, only 4 were found to have metastatically involved parotracheal regions, but juguiar regions without invoved; 98 cases to have metastasized jugular regions but parotracheal without involved. Obout 91 8% (90/98) of patients, the metastatic regional nodes were found in superior or mid jugular regions. The resuits showed that regional extensive resection could not remove the metastatic tumors spred these area.