中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2015年
8期
628-631
,共4页
蔡业丰%陈恩东%倪纯珏%李权%曾瑞超%张筱骅
蔡業豐%陳恩東%倪純玨%李權%曾瑞超%張篠驊
채업봉%진은동%예순각%리권%증서초%장소화
甲状腺肿瘤%淋巴结%淋巴转移%颈淋巴结清扫术
甲狀腺腫瘤%淋巴結%淋巴轉移%頸淋巴結清掃術
갑상선종류%림파결%림파전이%경림파결청소술
Thyroid neoplasms%Lymph nodes%Lymphatic metastasis%Neck dissection
目的:探讨甲状腺乳头状癌( PTC)颈部中央区淋巴结转移数目对颈侧区淋巴结转移的预测价值。方法2005年1月至2010年10月间收治的、经病理证实的133例PTC患者,均接受颈部中央区淋巴结及颈侧区淋巴结清扫术,将颈部中央区淋巴结转移数目与颈侧区淋巴结转移进行定量分析。结果颈部中央区淋巴结转移预测颈侧区淋巴结转移的敏感度为84.7%(61/72),阳性预测值为66.3%(61/92)。颈部中央区淋巴结转移数目与颈侧区淋巴结转移有关(r=0.911,P=0.004)。颈部中央区淋巴结转移<2枚和≥2枚患者的颈侧区淋巴结转移发生率分别为54.5%(12/22)和70.0%(49/70),差异无统计学意义(P=0.181);<3枚和≥3枚患者的颈侧区淋巴结转移发生率分别为50.0%(19/38)和77.8%(42/54),差异有统计学意义(P=0.006);<4枚和≥4枚患者的颈侧区淋巴结转移发生率分别为55.1%(27/49)和79.1%(34/43),差异有统计学意义(P=0.015);<5枚和≥5枚患者的颈侧区淋巴结转移发生率分别为57.6%(34/59)和81.8%(27/33),差异有统计学意义(P=0.019);<6枚和≥6枚患者的颈侧区淋巴结转移发生率分别为60.0%(39/65)和81.5%(22/27),差异有统计学意义( P=0.047)。结论 PTC患者颈部中央区淋巴结转移与颈侧区转移存在密切关系,颈侧区淋巴结转移主要出现在颈部中央区淋巴结转移数目≥3枚时。当PTC患者颈部中央区淋巴结转移数目≥3枚时,可作为预测颈侧区淋巴结转移的一个量化指标,考虑施行颈侧区淋巴结清扫术。
目的:探討甲狀腺乳頭狀癌( PTC)頸部中央區淋巴結轉移數目對頸側區淋巴結轉移的預測價值。方法2005年1月至2010年10月間收治的、經病理證實的133例PTC患者,均接受頸部中央區淋巴結及頸側區淋巴結清掃術,將頸部中央區淋巴結轉移數目與頸側區淋巴結轉移進行定量分析。結果頸部中央區淋巴結轉移預測頸側區淋巴結轉移的敏感度為84.7%(61/72),暘性預測值為66.3%(61/92)。頸部中央區淋巴結轉移數目與頸側區淋巴結轉移有關(r=0.911,P=0.004)。頸部中央區淋巴結轉移<2枚和≥2枚患者的頸側區淋巴結轉移髮生率分彆為54.5%(12/22)和70.0%(49/70),差異無統計學意義(P=0.181);<3枚和≥3枚患者的頸側區淋巴結轉移髮生率分彆為50.0%(19/38)和77.8%(42/54),差異有統計學意義(P=0.006);<4枚和≥4枚患者的頸側區淋巴結轉移髮生率分彆為55.1%(27/49)和79.1%(34/43),差異有統計學意義(P=0.015);<5枚和≥5枚患者的頸側區淋巴結轉移髮生率分彆為57.6%(34/59)和81.8%(27/33),差異有統計學意義(P=0.019);<6枚和≥6枚患者的頸側區淋巴結轉移髮生率分彆為60.0%(39/65)和81.5%(22/27),差異有統計學意義( P=0.047)。結論 PTC患者頸部中央區淋巴結轉移與頸側區轉移存在密切關繫,頸側區淋巴結轉移主要齣現在頸部中央區淋巴結轉移數目≥3枚時。噹PTC患者頸部中央區淋巴結轉移數目≥3枚時,可作為預測頸側區淋巴結轉移的一箇量化指標,攷慮施行頸側區淋巴結清掃術。
목적:탐토갑상선유두상암( PTC)경부중앙구림파결전이수목대경측구림파결전이적예측개치。방법2005년1월지2010년10월간수치적、경병리증실적133례PTC환자,균접수경부중앙구림파결급경측구림파결청소술,장경부중앙구림파결전이수목여경측구림파결전이진행정량분석。결과경부중앙구림파결전이예측경측구림파결전이적민감도위84.7%(61/72),양성예측치위66.3%(61/92)。경부중앙구림파결전이수목여경측구림파결전이유관(r=0.911,P=0.004)。경부중앙구림파결전이<2매화≥2매환자적경측구림파결전이발생솔분별위54.5%(12/22)화70.0%(49/70),차이무통계학의의(P=0.181);<3매화≥3매환자적경측구림파결전이발생솔분별위50.0%(19/38)화77.8%(42/54),차이유통계학의의(P=0.006);<4매화≥4매환자적경측구림파결전이발생솔분별위55.1%(27/49)화79.1%(34/43),차이유통계학의의(P=0.015);<5매화≥5매환자적경측구림파결전이발생솔분별위57.6%(34/59)화81.8%(27/33),차이유통계학의의(P=0.019);<6매화≥6매환자적경측구림파결전이발생솔분별위60.0%(39/65)화81.5%(22/27),차이유통계학의의( P=0.047)。결론 PTC환자경부중앙구림파결전이여경측구전이존재밀절관계,경측구림파결전이주요출현재경부중앙구림파결전이수목≥3매시。당PTC환자경부중앙구림파결전이수목≥3매시,가작위예측경측구림파결전이적일개양화지표,고필시행경측구림파결청소술。
Objective The aim of this study was to evaluate the number of central cervical lymph node metastasis (CCLNM) in predicting lateral cervical lymph node metastasis (LCLNM) in patients with papillary thyroid carcinoma ( PTC) . Methods From January 2005 to October 2010, a total of 133 patients diagnosed as PTC underwent central and lateral cervical lymph node dissection were enrolled in this study. Quantitative analysis was performed to explore the correlation between the number of CCLNM and LCLNM. Results The sensitivity of central cervical node metastasis to predict lateral cervical node metastasis was 84.7%(61/72), and the positive predictive value (PPV) was 66.3% (61/92). The incidence of lateral cervical LNM was correlated with the number of CCLNM ( r=0. 911, P=0. 004 ) . The LCLNM rates in patients with number of CCLNM <2 and≥2 were 54.5% (12/22) and 70.0% (49/70), respectively, with a non?significant difference ( P=0.181) . The LCLNM rates in patients with number of CCLNM <3 and ≥3 were 50.0% (19/38) and 77.8% (42/54), showing a significant difference (P=0.006). The LCLNM rates in patients with number of CCLNM <4 and ≥4 were 55. 1% ( 27/49 ) and 79. 1% ( 34/43 ) , with a significant difference ( P=0.015) . The LCLNM rates in patients with number of CCLNM <5 and ≥5 with the LLNM rate were 57.6% (34/59) and 81.8% (27/33), showing a significant difference (P=0.019). The LCLNM rates in patients with number of CCLNM <6 and ≥6 were 60.0% (39/65) and 81.5% (22/27) , showing a significant difference ( P=0.047) . Conclusions CCLNM has a significant association with LCLNM in patients with papillary thyroid carcinoma. LCLNM is mainly observed in patients with ≥3 CCLNM. Therefore, the number of CLNM ≥3 may be a valuable predictor of lateral cervical lymph node metastasis, and lateral cervical lymph node dissection should be considered.