甲状腺微小癌距包膜距离与颈部淋巴结转移的关系

Relationship between the distance of thyroid microcarcinoma from capsule and cervical lymph node metastasis

目的探讨甲状腺微小癌结节距甲状腺包膜的最小距离与颈部淋巴结转移的关系。方法回顾性分析2015年1月至2018年1月在常州市第二人民医院甲状腺外科经手术及病理证实的138例甲状腺微小癌(155个癌结节)患者的临床资料。癌结节距甲状腺包膜的最小距离≥0.5 cm者为A组,最小距离<0.5 cm者为B组,分析甲状腺微小癌结节距甲状腺包膜距离与颈部淋巴结转移的关系。结果 A组53个微小癌结节,2个有颈部淋巴结转移,51个无颈部淋巴结转移,转移率3.8%;B组102个微小癌结节,66个有颈部淋巴结转移,36个无颈部淋巴结转移,转移率64.7%。两组的差异有统计学意义(P=0.00)。依据颈部淋巴结分区,155个微小癌结节共计出现117处淋巴结分区的转移情况,51.3%(60/117)位于Ⅵ区,各有13.7%(16/117)位于Ⅲ区和Ⅳ区,12.0%(14/117)位于Ⅴ区,9.4%(11/117)位于Ⅱ区。结论甲状腺癌结节距甲状腺包膜距离与颈部淋巴结转移有关,距包膜距离越近越容易发生颈部淋巴结转移;转移淋巴结分区以Ⅵ区为主。

Objective To study the relationship between the distance of thyroid microcarcinoma(TMC) from capsule and cervical lymph node metastasis. Methods TMC in 138 cases(a total of 155 lesions) diagnosed by operation and pathology were analyzed retrospectively. Minimum distance of TMC from thyroid capsule were measured. Cervical lymph nodes metastasis were noted. The minimum distance ≥ 0.5 cm was divided into group A, the minimum distance<0.5 cm was divided into group B. The relationship between the distance of TMC from capsule and cervical lymph node metastasis was analyzed.Results There were 53 lesions in group A, two lesions(3.8%) emerged cervical lymph nodes metastasis. There were 102 lesions in group B, 66 lesions(64.7%) emerged cervical lymph nodes metastasis. According to cervical lymph nodes areal divison, a total of 117 areas cervical lymph nodes metastasis were confirmed by postoperative pathology. 51.3%(60/117)located in area Ⅵ, 13.7%(16/117)in area Ⅲ, 13.7%(16/117)in area Ⅳ, 12.0%(14/117)in areaⅤ, 9.4%(11/117)in area Ⅱ. Conclusions The distance between TMC nodules and thyroid capsule is related to cervical lymph node metastasis. Metastatic lymph nodes are mainly in area Ⅵ.