CAJ | 학술논문

背景与目的:甲状腺乳头状癌淋巴转移规律及清扫方法是当前甲状腺外科的研究热点,本研究探讨甲状腺乳头状癌临床颈部淋巴结阴性患者(cN0)发生Ⅵ区淋巴转移的影响因素及临床意义.方法:回顾性分析2011年在江苏省原子医学研究所附属江原医院行全甲状腺切除+颈Ⅵ区淋巴清扫术的305例甲状腺乳头状癌患者临床资料.根据术后病理检查分为淋巴结转移组(134例)和淋巴结未转移组(171例),进行单因素和多因素Logistic回归分析研究.结果:甲状腺乳头状癌淋巴转移率为43.93%,单因素分析发现年龄、双叶癌、包膜侵犯和非微小癌等因素对淋巴结转移的影响差异有统计学意义(P<0.05),多因素分析证实年龄≥45岁、肿瘤侵犯包膜为Ⅵ区淋巴结转移的危险因素.结论:cN0甲状腺乳头状癌有较高的淋巴结转移率,在切除甲状腺的同时清扫颈Ⅵ区的淋巴结是十分必要的.
배경여목적:갑상선유두상암림파전이규률급청소방법시당전갑상선외과적연구열점,본연구탐토갑상선유두상암림상경부림파결음성환자(cN0)발생Ⅵ구림파전이적영향인소급림상의의.방법:회고성분석2011년재강소성원자의학연구소부속강원의원행전갑상선절제+경Ⅵ구림파청소술적305례갑상선유두상암환자림상자료.근거술후병리검사분위림파결전이조(134례)화림파결미전이조(171례),진행단인소화다인소Logistic회귀분석연구.결과:갑상선유두상암림파전이솔위43.93%,단인소분석발현년령、쌍협암、포막침범화비미소암등인소대림파결전이적영향차이유통계학의의(P<0.05),다인소분석증실년령≥45세、종류침범포막위Ⅵ구림파결전이적위험인소.결론:cN0갑상선유두상암유교고적림파결전이솔,재절제갑상선적동시청소경Ⅵ구적림파결시십분필요적.
Background and purpose:The way of the lymph node metastases and the method of lymph node dissection of papillary thyroid carcinoma (PTC) are currently the research focus of thyroid surgery. This study was to analyze the risk factors of level Ⅵ lymph node involvement for patients with PTC without clinical cervical lymph node metastasis (cN0). Methods:Consecutive 305 cases underwent total thyroidectomy and level VI lymph node dissection from Jan. 2011 to Dec. 2011 were analyzed retrospectively. According to the postoperative pathology results, univariate and multivariate logistic regression analysis were used to analyze risk factors. Results:The central compartment lymph node metastasis rate of PTC patients was 43.93%. Tumor size, age, extra-capsular invasion, and bilateral lesions were significantly corrrelated to lymph node metastasis (P<0.05). The (cN0) PTC has a high rate of pathological lymph node metastasis, especially in patients with age more than 45 years old, extra-capsular invasion. Conclusion:It is important to conduct the thyroidectomy with ipsilateral level Ⅵ lymph node dissection of PTC patients.