Ⅵ区各组淋巴结清扫在cN0期甲状腺乳头状癌手术中的意义

The significance of lymph node dissection in the Ⅵ area of cN0 thyroid papillary carcinoma

目的:探讨Ⅵ区各组淋巴结清扫在cN0期甲状腺乳头状癌手术中的意义。方法:收集确诊为cN0甲状腺乳头状癌并行Ⅵ区各组淋巴结清扫的患者150例,行患侧甲状腺腺叶+峡部切除,同期行患侧Ⅵ区淋巴结清扫。对甲状腺和清扫的Ⅵ区各组淋巴结进行病理检查并测定甲状腺乳头状癌的大小、部位、是否有膜侵犯、淋巴结数目、淋巴结是否转移等。结果:150例患者均行Ⅵ区各组淋巴结清扫,93例发现Ⅵ区淋巴结转移,转移率为62.0%。Ⅵ区中各组淋巴结转移率:气管旁淋巴结组62.0%(93/150),喉前淋巴结组4.67%(7/150),气管前淋巴结组3.33%(5/150),其中气管旁喉返神经腹侧淋巴结组52.0%(78/150),气管旁喉返神经背侧淋巴结组21.33%(32/150)。结论:cN0甲状腺乳头状癌Ⅵ区淋巴结转移率高,转移率由高到低依次为:气管旁淋巴结组、喉前淋巴结组、气管前淋巴结组,其中气管旁喉返神经腹侧淋巴结组在中央区各组淋巴结中转移率最高。

Objective：The significance of lymph node dissection in the Ⅵ area of cN0 thyroid papillary carcino- ma. Method： Collect 150 cases of patients diagnosed with cN0 thyroid papillary carcinoma and they were performed thyroid gland lobe and isthmic portion excision including lateral Ⅵ area lymph node cleaning. The specimens were pathologic examined to determinate the size, the position, invasion of thyroid papillary carcinoma,the number and metastasis of lymph node, etc. Result：In the 150 patients performed the lymph node Ⅵ area groups cleaning, 93 cases had VI area of lymph node metastases, so the transfer rate was 62.00/60. In the VI area, metastasis rate of tracheal side lymph nodes was 62.0% （93/150）, lymph node before throat group was 4.67% （7/150）, lymph node before trachea group was 3.33% （5/150）, lymph nodes near the trachea laryngeal recurrent nerve ventral group was 52.0% （78/150） ,and next to the trachea laryngeal recurrent nerve dorsal lymph node group was 21.33% （32/ 150）. Conclusion：In CN0 thyroid papillary carcinoma, VI zone of lymph node metastasis rate is high, and region Ⅵ lymph node metastasis rate from high to low in order for： paratracheal lymph node, prelaryngeal lymph node, pre- tracheal lymph node. The metastasis rate of paratracheal throat back nerve ventral lymph node was the highest in central lymph node.