甲状腺微小乳头状癌中Delphain淋巴结与颈不同区域淋巴结转移的相关性研究进展

Advances in the correlation between Delphain lymph nodes and lymph node metastasis in different cervical regions in thyroid micropapillary carcinoma

甲状腺微小乳头状癌(PTMC)是指直径≤1 cm的甲状腺乳头状癌(PTC),恶性程度较低、整体预后较好,这可能与PTMC的惰性有关。但其在疾病早期仍容易发生局部淋巴结转移,有术后复发的风险。PTC颈部淋巴结转移好发生于中央区,目前已研究证实作为中央区的亚区淋巴结,Delphain淋巴结(DLN)为PTC最常转移的局部淋巴结区域,也是PTMC预后不良的标志。原发性肿瘤>1 cm、甲状腺腺外侵犯和峡部受累、肿瘤多灶性、包膜侵犯、淋巴血管侵犯等被认为是DLN转移的高危因素。目前对于DLN转移在PTMC疾病进展中的相关性研究仍不充分,本文从DLN转移规律及危险因素、DLN转移对于PTMC患者手术范围的制定及预后的影响等方面进行综述。

Papillary thyroid microcarcinoma (PTMC),a ≤1 cm-diameter thyroid papilloma (PTC),is a relatively inert subtype of thyroid cancer with low malignancy and relatively good overall prognosis.Local lymph node metastasis,on the other hand,is still susceptible to early stages of the disease,and there is a risk of recurrence after surgery.Thyroid papilloma cancer neck lymph node metastasis occurs in the central region,whereas the pre-throat lymph nodes,also known as Delphain lymph nodes (DLN),as the central region of the sub-region lymph nodes,has been confirmed as the most commonly transferred local lymph node region of PTC,and also a sign of PTMC’s poor prognosis.Thyroid aggression and isthmus strain,tumor polysacousticity,capsule aggression,lymphatic vascular aggression,and other factors are thought to be high risk factors for DLN metastasis.There is currently relatively little association between DLN metastasis and the course of PTMC disease,thus this study analyzes the law of DLN metastasis and risk factors,the relevance of DLN metastasis for PTMC patients’ operation scope and prognosis,and so on.