甲状腺乳头状癌术中行预防性中央区淋巴结清扫的价值

目的探讨中央区颈淋巴结清扫术对甲状腺乳头状癌手术的临床意义。方法收集术前行颈部彩超同时行颈部、上纵隔薄层增强CT检查的171例甲状腺乳头状癌的手术病理资料，对照手术病理结果分析术前彩超组、彩超联合CT组检查评估甲状腺乳头状癌中央区淋巴结转移的准确性，比较诊断效能。结果术前单一彩超评估颈中央区淋巴结转移准确率31．58％（54／171），彩超联合CT检查评估颈中央区淋巴结转移准确率45．61％（78／171），两组间差异有统计学意义（P〈0．05）；术中预防性颈中央区淋巴结清扫病理学检查证实转移率60．82％（104／171），其与联合检查两组间差异有统计学意义（P〈0．05）。结论术中行预防性颈中央区淋巴结清扫对于改善甲状腺乳头状癌患者预后将起到积极作用。

Objective To assess the clinical benefits of prophylactic central neck dissection （ pCND ） in patients with papillary thyroid cancer （ PTC ） . Method Clinical data of 171 cases with PTC were collected.All had undergone ultrasound in neck and enhanced CT both in neck and inimediastinum before surgery.They were divided into ultrasound group, and the combination of ultrasound and enhanced CT group and intra- operational prophylactic central neck dissection group to evaluate lymph node metastasis. Result For the central compartment, the accuracy of ultrasound was 31.58%, the combination of ultrasound and CT was 45.61%, the combination of ultrasound and CT had higher accuracy than ultrasound （ P〈0.05 ） ; the accuracy of pathological results with intra-operational prophylactic central neck dissection was 60.82%, and higher accuracy than the combination of ultrasound and CT （ P〈0.05 ） . Conclusion Prophylactic Central Neck Dissection in Papillary Thyroid Carcinoma can mprove quality of life in patients.