甲状腺乳头状癌颈淋巴结转移途径的探讨

The Lymphonode Metastatic Pathway in Papillary Adenocarcinoma of the Thyroid

探讨甲状腺乳头状腺癌颈淋巴结转移途径的规律及其临床意义。方法:1991年1月～2002年5月,为97例甲状腺乳头状腺癌颈淋巴结转移的病人作了108次功能性颈淋巴结清扫术。参照美国耳鼻咽喉头颈外科基金协会颈淋巴结分区法,分析淋巴结转移的规律。结果:Ⅵ、Ⅳ、Ⅲ区淋巴结转移最为常见,转移率分别为78.5%、70.3%、68.5%;尤其在转移早期的Ⅳ和Ⅲ区转移中,转淋巴结多位于颈内静脉后方,单靠触诊不易发现;Ⅰ区较少淋巴结转移;Ⅱ、Ⅴ区淋巴结转移率居中。结论:本研究的发现有助于甲状腺乳头状腺癌手术时前哨淋巴结活检的设计,并恰当地选择清扫区域和范围。

Objective:To explore the rule of lymphonode metastatic pathway of in papillary adenocarcinoma of the thyroid gland and its clinical significance.Methods:Ninety-seven patients undergoing108times of functional radical neck dis-section and were analyzed as to the rule of lymphonode metastasis.Results:The incidence of lymphonode metastasis in regionsⅥ,ⅣandⅢwas78.5%,70.3%,and68.5%respectively.In earlier stage of the disease,the metastatic lymphon-odes in regionsⅣandⅢwere frequently located posterior to the internal jugular vein and could hardly be found by pal-pation;there were few metastatic lymphonodes in regionⅠ;the condition in regionsⅡandⅤwas between the two groups above mentioned.Conclusions:This study alludes to the benefit of sentinel lymph node biopsy which will serve as a basis for radical neck dissection.