cN0甲状腺乳头状癌患者首次治疗中常规行预防性中央区淋巴结清扫的意义

The Significance on the Patients with cN0 Papillary Thyroid Cancer for the First time Routine Prophylactic Central Lymph Node Dissection

目的:探讨cN0甲状腺乳头状癌患者首次治疗中常规行预防性中央区淋巴结清扫的意义。方法:选取2009年5月至2015年2月在我院诊断为cN0甲状腺乳头状癌患者72例,常规行预防性中央区淋巴结清扫术,观察术后并发症以及随访预后情况,比较患者临床病理资料与中央区淋巴结转移关系。结果:术后病理显示中央区淋巴结转移率为30.56%。肿瘤穿透甲状腺被膜者中央区淋巴结转移率为53.33%,明显高于未穿透者的14.29%,差异有统计学意义(P<0.05);多发肿瘤患者中央区淋巴结转移率为70.00%,明显高于单发肿瘤患者的24.19%,差异有统计学意义(P<0.05);不同年龄、性别、肿瘤直径、肿瘤单双侧患者中央区淋巴结转移率差异无统计学意义(P>0.05);患者术后出现并发症患者3例,其中1例为暂时性喉返神经损伤,2例为暂时性甲状旁腺功能低下。患者给予治疗后,症状均在术后2~6个月消失。随访期间无死亡病例发生。结论:cN0甲状腺乳头状癌患者首次治疗中常规行预防性中央区淋巴结清扫是必要、安全的处理方式。

Objective:To investigate cN0 papillary thyroid cancer patients for the first time in the treatment of routineprophylactic central lymph node dissection significance.Methods:From 2009 May to 2015 February in our hospital,72 cases of patients with papillary thyroidcarcinoma were selected.All the patients were underwent routine prophylactic central lymph node dissection.The postoperative complications and prognosis were observed and the clinical pathological data and central lymph node metastasis were compared.Results:Postoperative pathology showed the central lymph node metastasis rate was 30.56%.tumor penetration thyroid membrane central lymph node metastasis rate was 53.33%,significantly higher than that of non penetrating 14.29%,the difference was statistically significant(P<0.05);Multiple tumors in patients with central lymph node metastasis rate was 70%,significantlyhigher than that of single tumor in 24.19%patients,the difference was statistically significant(P<0.05);The different age,gender,tumor diameter,tumor unilateral and bilateralpatientscentral lymph node metastasis rate showed no statistical significance(P>0.05);Patients with postoperative complications in 3 cases,including 1 case of transient recurrent nerve injury,2 cases of transient hypoparathyroidism.Patients were given aftertreatment,all symptomsinthe postoperative 2~6 months away.No deaths occurred during the follow-up period.Conclusion:cN0 papillary thyroid cancer for the first time in the treatment of routine prophylactic central lymph node dissection approach is necessary and safe.