甲状腺微小癌淋巴结转移及外科处理策略的探讨

Lymph Node Metastasis and surgical strategic management in Thyroid Microcarcinoma

目的:分析甲状腺微小癌(thyroid microcarcinoma,TMC)的临床因素对颈部淋巴结转移的影响。方法:回顾性收集我院2002年1月～2009年1月通过手术治疗的106例TMC患者的临床资料进行整理,根据是否发生淋巴结转移分为转移组和未转移组,通过单因素分析进行研究。结果:106例的TMC发生淋巴结转移率为24.5%(26/106),随访期间无死亡病例,以肿瘤最大直径≥0.7cm和甲状腺被膜侵犯对淋巴结转移的影响有统计学意义。结论:TMC分类分期及治疗原则尚未达成一致,对于肿瘤最大直径≥0.7cm以及甲状腺被膜受侵犯等高危因素患者,术中的细致探查及择区性淋巴结清扫对TMC复发及预后具有重要意义。

Objective To analyze the clinical factors influencing on lymph node metastasis in thyroid microcarcinoma（TMC） patients. Method Retrospectively collecting 106 cases of TMC with operations from Jan 2002 to Jan 2009,divided 106 cases into two groups（metastasis group and non-metastasis group） according to whether or not happening metastasis,then through single factor method to study.Result TMC patients in this study,the lymph node metastasis rate was 24.5%（26/106）,no cases dead in follow-up,through this study we found that he maximum tumor diameter≥0.7cm and thyroid capsule invasion significant affcted lymph node metastasis.Conclusion The classification and principles of surgical management of TMC had not reached a agreement,for the maximum tumor diameter≥0.7cm and the thyroid capsule invasion of cases,detailed exploration and selective lymph node dissection is necessary and effective.