乳头状甲状腺癌胸锁乳突肌与胸骨舌骨肌之间淋巴结转移的临床特征分析

Clinicopathological features of metastasis of lymph nodes between sternocleidomastoid and sternohyoid muscle in papillary thyroid carcinoma

目的探讨乳头状甲状腺癌(papillary thyroid carcinoma,PTC)颈前下部胸锁乳突肌与胸骨舌骨肌之间淋巴结(lymph node between sternocleidomastoid and sternohyoid muscle,LNSS)转移的临床特点及相关影响因素。方法回顾性分析126例PTC患者进行手术治疗的临床资料,计数LNSS数目,计算该组淋巴转移率,测定转移淋巴结最长径。对性别、年龄、甲状腺肿瘤最长径、原发灶侧别、肿瘤部位、多发癌灶、颈前带状肌侵犯、颈部多发淋巴结转移等7个因素与颈前下部LNSS转移的相互关系进行分析。结果 18例患者出现该组淋巴结转移,转移率14.3%;转移淋巴结共29个,平均最长径(0.5±0.12)cm。与未发生转移的患者比较,LNSS转移的患者同时发生颈中央区及颈侧区多发淋巴结转移的比例高(P﹤0.05),肿瘤侵犯颈前带状肌较常见(P﹤0.05)。两组患者年龄、性别、肿瘤最长径大小、原发灶侧别、肿瘤发生部位、多发癌灶比例经比较差异无统计学意义(P﹥0.05)。结论颈部多发淋巴结转移和带状肌侵犯的PTC患者易同时发生LNSS转移。

Objective To evaluate clinicopathological features of metastasis of lymph nodes between stemocleidomastoid and sternohyoid muscle （ LNSS ） in papillary thyroid carcinoma （ FFC ） . Methods Clinical data of 126 patients with PTC treated surgically was retrospective analyzed. The correlations between LNSS metastasis and patients＇ sex, age, the longest diameter of tumor, primary side, multiple loci, strap muscles involvement and lymphatic metastasis of multiple regions were analyzed. Results LNSS metastasis was confirmed in 18 patients with a metastatic rate of 14. 3%. The average diameter of 29 positive nodes of LNSS was （0. 5 ± 0. 12） cm. The incidences of strap muscle involvement and muhiregional lymphatic metastasis in patients with LNSS metastasis were higher than those without LNSS metastasis （ both P 〈 0.05 ）. The differences of patients ＇ sex, age, the longest diameter of tumor, primary side and multiple foci between them were statistically insignificant （all P 〉 0. 05 ）. Conclusion PTC patients with strap muscle involvement and multiregional lymphatic metastasis are apt to have simultaneous LNSS metastasis.