甲状腺炎合并甲状腺癌颈淋巴结转移情况及相关因素探讨

Neck Lymph Node Metastasis and Related Factors in Thyroiditis Coexisting Thyroid Cancer

目的探讨甲状腺炎合并甲状腺癌患者颈淋巴结转移的情况及相关因素,以明确淋巴结清扫术的指征。方法回顾性分析147例甲状腺炎合并甲状腺癌行甲状腺癌根治术同时行颈淋巴结清扫术患者的临床资料,对患者性别、年龄、肿瘤大小及病灶数与淋巴结转移的关系进行总结分析。结果 147例患者中有65例伴颈淋巴结转移,总转移率为44.22%。其中中央组淋巴结转移率为36.05%(53/147),明显高于侧颈淋巴结的20.41%(30/147),P<0.05。性别、肿瘤大小与淋巴结转移有关(P<0.05),而年龄和病灶数多少与淋巴结转移无关(P>0.05)。结论甲状腺炎合并甲状腺癌患者的颈中央组淋巴结有较高的转移率,故手术时常规行中央组淋巴结清扫术有一定意义。性别和肿瘤大小与颈淋巴结转移有关,对于男性、肿瘤较大患者,应考虑是否同时行同侧颈淋巴结清扫术。

Objective To investigate the condition of neck lymph node metastasis and related factors in thyroiditis coexisting thyroid cancer,and make clear the indication of neck lymph node dissection.Methods A retrospective cohort study was conducted with the clinical data of 147 patients with thyroiditis coexisting thyroid cancer who underwent radical resection of thyroid cancer（total thyroidectomy or subtotal thyroidectomy） and neck lymph node dissection,including age,gender,tumor size,number of focuses,and lymph node metastasis.Results Among 147 patients,65 patients with neck lymph node metastasis（44.22%）,central cervical lymph node metastasis rate was 36.05%（53/147）,which was higher than that of lateral lymph node metastasis rate（20.41%,30/147）,P0.05.Neck lymph node metastasis rate was correlated with patient＇s gender and tumor size（P0.05）,while it was not correlated with patient＇s age and number of focuses（P0.05）.Conclusion Central neck lymph node metastasis rate is higher in patients with thyroiditis coexisting thyroid cancer,then routine prophylactic central neck lymph node dissection is significant.Patient＇s gender and tumor size are correlated with neck lymph node metastasis.When tumor is larger or in male,ipsilateral lymph node dissection should be considered to done.