单侧结节甲状腺乳头状癌cN0患者中央区淋巴结转移的影响因素分析

Factors of central district lymph node metastasis in cN0 papillary unilateral nodules thyroid carcinoma patients

目的探讨单侧结节甲状腺乳头状癌患者cN0中央区淋巴结转移的影响因素。方法选择97例单侧结节甲状腺乳头状癌(PTC)cN0患者,观察并分析影响中央区淋巴结转移的影响因素。结果年龄<45岁,肿瘤最大径≥1 cm、甲状腺被膜被侵袭的患者发生同侧气管旁淋巴结转移的可能性较高;肿瘤最大径>1 cm、甲状腺被膜被侵袭以及已发生同侧气管旁淋巴结转移的患者易发生气管前淋巴结转移。肿瘤最大径≥1 cm、已发生同侧气管旁淋巴结转移或气管前淋巴结转移者易发生喉前淋巴结转移。结论对肿瘤最大径≥1 cm、甲状腺被膜被侵袭的患者应进行同侧气管旁+气管前淋巴结清扫,对发生同侧气管旁淋巴结转移或气管前淋巴结转移者宜行喉前淋巴结清扫。

Objective To investigate the factors of central district lymph node metastasis in c N0 papillary unilateral nodules thyroid carcinoma patients. Methods Ninety- seven patients with c N0 unilateral nodules papillary thyroid carcinoma were collected. The affected factors of central lymph node metastasis were observed and analyzed. Results Patients with age 45 years,maximum tumor diameter ≥1 cm and thyroid capsule invasion had a high probability of the occurrence of ipsilateral paratracheal lymph node metastasis. Patients with tumor size 1 cm,thyroid capsule invasion and the occurrence of ipsilateral paratracheal lymph node metastasis prone to have pretracheal lymph node metastasis. Patients with maximum tumor diameter ≥1 cm and ipsilateral paratracheal lymph node metastasis or pretracheal lymph node metastasis prone to have prela-ryngeal lymph node metastasis. Conclusion To patients with maximum tumor diameter ≥1 cm and thyroid capsule invasion,we should take ipsilateral paratracheal and pretracheal lymph node dissection. To patients with the existence of ipsilateral paratracheal or pretracheal lymph node metastasis,we should take prelaryngeal lymph node dissection.