甲状腺癌行甲状腺全切+中央区淋巴结清扫术后喉返神经附近发生淋巴结转移的高危因素分析

Risk factors analysis of lymph node metastasis near the recurrent laryngeal nerve after thyroid cancer with total thyroidectomy and central lymph node dissection

目的研究甲状腺癌行甲状腺全切+中央区淋巴结清扫术后喉返神经附近发生淋巴结转移的高危因素,分析进行预防性颈部淋巴结清扫术的意义。方法回顾性分析我院2009～2013年诊断为甲状腺微小乳头状癌(PTMC),行甲状腺全切+中央区淋巴结清扫术116例患者,分析其临床资料,探讨临床特征和喉返神经附近淋巴结转移的关系。结果单因素分析PTMC患者淋巴结转移和年龄、性别、腺外侵犯、特殊类型、双侧肿瘤以及多灶性相关(P <0.05),多因素分析PTMC患者淋巴结转移和患者年龄、性别、肿瘤大小、双侧肿瘤、腺外侵犯、多灶性相关。结论 PTMC患者喉返神经附近发生淋巴结转移与其性别、年龄、双侧肿瘤、侵出腺叶、肿瘤大小、以及多灶性有关。高危因素PTMC患者需要进行预防性颈部淋巴结清扫术,而无高危因素PTMC患者没有必要进行预防性颈部淋巴结清扫术。

Objective To investigate the risk factors of lymph node metastasis near the recurrent laryngeal nerve after thyroid cancer with total thyroidectomy and central lymph node dissection,to analyze the significance of prophylactic cervical lymph node dissection. Methods 116 patients’ data who diagnosed papillary thyroid microcarcinoma （PTMC） with total thyroidectomy and central lymph node dissection in our hospital from 2009 to 2013 were retrospectively analyzed.The clinical features and the relationship of lymph node metastasis near the recurrent laryngeal nerve were explored. Results Lymph node metastasis in PTMC patients was related to age,gender,extra-glandular invasion,special types,bilateral tumors,and multifocal by univariate analysis （P 〈0.05）,Lymph node metastasis in PTMC patients was related to age,gender,tumor size,bilateral tumor,extra-glandular invasion and multifocal by multi-factor analysis. Conclusion Lymph node metastasis near the recurrent laryngeal nerve in PTMC patients is related to age,gender,bilateral tumors,extra-glandular invasion,tumor size and multifocal.PTMC patients with high-risk factors need prophylactic cervical lymph node dissection,and there is no need for PTMC patients without high-risk factors.