双侧中央区淋巴结清扫在单侧分化型甲状腺癌治疗中的意义

Significance of bilateral central compartment lymph node dissection in the treatment of unilateral differentiated thyroid cancer

目的探讨单侧分化型甲状腺癌行双侧中央区淋巴结清扫的临床意义。方法 80例单侧分化型甲状腺癌患者均行患侧腺叶全切除,对侧腺叶近全切除,加双侧中央区淋巴结清扫,观察中央区淋巴结转移情况。结果80例患者中,中央区淋巴结转移率为70.00%。年龄﹤45岁、非微小癌、cN1期患者中央区淋巴结转移率分别明显高于年龄≥45岁、微小癌、cN0期患者,差异均有统计学意义(P﹤0.01)。有11.25%的患者出现暂时性低钙血症,无永久性低钙血症发生,有10.00%的患者出现暂时性声音嘶哑;术中无喉返神经损伤。结论单侧分化型甲状腺癌患者中央区淋巴结转移率较高,行双侧中央区淋巴结清扫有较高的临床应用价值。

Objective To investigate the clinical significance of bilateral central compartment lymph node dissection in the treatment of unilateral differentiated thyroid cancer.Method Totally,80 patients with unilateral differentiated thyroid cancer with total lobectomy of the affected side,contralateral subtotal lobectomy,combining central compartment lymph node dissection were included in the analysis,the lymph node metastasis in the central compartment were observed.Result Among the 80 patients,the metastasis rate of lymph node in central compartment was 70.00%.The lymph node metastasis rates of patients aged<45 years,with non-microcarcinoma and stage cN1 lesions were significantly higher than those in patients≥45 years of age,with microcarcinoma and stage cN0 disease,the differences were statistically significant(P<0.01).Temporary hypocalcemia occurred in 11.25%of patients,and no permanent hypocalcemia was noted,besides,temporary hoarseness was seen in 10.00%of patients,and no recurrent laryngeal nerve injury was induced during the operation.Conclusion The lymph node metastasis rate in central compartment of unilateral differentiated thyroid cancer patients is elevated,and bilateral central compartment lymph node dissection demonstrates high clinical value.