颈中央区淋巴结数目及分布的临床解剖学研究

Quantification and distribution of lymph nodes in the central neck compartment: clinical anatomic study

目的探讨颈中央区淋巴结的数目及分布规律。方法回顾分析2013年6月-2016年6月在我科行中央区淋巴结清扫术的甲状腺乳头状癌患者的临床资料。统计分析颈部中央区及各亚区淋巴结的数目。结果双侧中央区淋巴结(9.86±3.36)枚(4~20枚)。左侧中央区淋巴结(6.24±2.23)枚(2~14枚)。右侧中央区淋巴结(7.77±2.79)枚(2~15枚)。喉前区淋巴结(1.29±0.75)枚(0~4枚),气管前区(2.62±1.26)枚(0~7枚),左侧气管旁区(2.38±1.34)枚(0~6枚),右侧气管旁区(3.97±1.97)枚(0~10枚)。四个亚区淋巴结比例分别为:12.69%,24.47%,24.15%,38.47%。其中右侧气管旁区的两个亚区右侧喉返神经外侧区(1.35±1.27)枚(0~6枚),右侧喉返神经内侧区(2.64±1.75)枚(0~9枚)。结论本研究报道颈中央区淋巴结的数目及分布结果,可为外科医生在行颈中央区淋巴结清扫术时提供解剖学依据。

Objective To study the quantification and distribution of lymph nodes in central neck compartment（CNC）. Methods The data of 304 patients who had papillary thyroid cancer that underwent unilateral/bilateral central neck dissection（CND） from June 2013 to June 2016 were analyzed. The fresh CNC specimen was separated into four sublevel（prelaryngeal region, pretracheal region, left paratracheal region,right paratracheal region）, and underwent pathologic examination, respectively. The number of lymph nodes was counted. Results The lymph nodes yielded in CND were as follows： bilateral CCN：（9.86 ± 3.36）（4～20）;left CCN：（6.24±2.23）（2～14）;right CCN：（7.77±2.79）（2～15）. The lymph node distribution of CND was as follows： precricoid region：（1.29 ± 0.75）（0～4）; pretracheal region：（2.62 ± 1.26）（0～7）; left paratracheal region：（2.38 ± 1.34）（0～6）; right paratracheal region：（3.97 ± 1.97）（0～10）. The ratio of the four region was12.69%,24.47%,24.15%,and 38.47%, respectively. The lymph node distribution of the right paratracheal region was as follows： lateral region of the right recurrent laryngeal nerve：（1.35±1.27）（0～6）; medial region of the right recurrent laryngeal nerve：（2.64±1.75）（0～9）. Conclusion Our study was the first one to report the quantification and distribution of lymph nodes in the central neck compartment in China, which can provide anatomic basis for surgeon during central neck dissection.