中华内分泌外科杂志
中華內分泌外科雜誌
중화내분비외과잡지
Journal of Endocrine Surgery
2015年
5期
405-408
,共4页
龚文博%张松涛%翟翼飞%黑虎%秦建武
龔文博%張鬆濤%翟翼飛%黑虎%秦建武
공문박%장송도%적익비%흑호%진건무
甲状腺乳头状癌%微小癌%淋巴结转移%颈淋巴结清扫
甲狀腺乳頭狀癌%微小癌%淋巴結轉移%頸淋巴結清掃
갑상선유두상암%미소암%림파결전이%경림파결청소
Papillary thyroid carcinoma%Microcarcinoma%Lymph node metastasis%Neck dissec-tion
目的：探索cN0期甲状腺乳头状微小癌（ papillary thyroid microcarcinoma ，PTMC）淋巴结转移规律，并评价其颈部淋巴结清扫范围。方法对233例cN0期PTMC的临床资料行回顾性分析，用χ2检验对性别、年龄、肿瘤直径与淋巴结转移之间的关系作单因素分析。结果233例cN0期PTMC患者颈部淋巴结转移率34.8％（中央区30.0％，侧颈部9.9％）。肿瘤直径≤5 mm者与＞5 mm者中央区淋巴结转移率分别为21.6％和36.6％（χ2＝6.199，P＜0.05），侧颈部淋巴结转移率分别为4.9％和13.7％（χ2＝5.035，P＜0.05）；男性与女性中央区淋巴结转移率分别为42.1％、26.1％（χ2＝5.224，P＜0.05），侧颈部淋巴结转移率分别为21.1％、6.3％（χ2＝10.604，P＜0.01）。年龄≤45岁和＞45岁者的中央区淋巴结转移率分别为37.9％、21.1％（χ2＝7.792，P＜0.01）。中央区淋巴结转移时侧颈部淋巴结转移率为17.1％，中央区淋巴结未转移而发生侧颈淋巴结转移率为6.7％（χ2＝5.947，P＜0.05）。结论 cN0期PTMC患者均应规范性清扫中央区淋巴组织，对于肿瘤直径＞5 mm的男性PTMC患者应积极探查侧颈部淋巴组织，以发现亚临床转移癌灶，指导进一步手术方案。
目的：探索cN0期甲狀腺乳頭狀微小癌（ papillary thyroid microcarcinoma ，PTMC）淋巴結轉移規律，併評價其頸部淋巴結清掃範圍。方法對233例cN0期PTMC的臨床資料行迴顧性分析，用χ2檢驗對性彆、年齡、腫瘤直徑與淋巴結轉移之間的關繫作單因素分析。結果233例cN0期PTMC患者頸部淋巴結轉移率34.8％（中央區30.0％，側頸部9.9％）。腫瘤直徑≤5 mm者與＞5 mm者中央區淋巴結轉移率分彆為21.6％和36.6％（χ2＝6.199，P＜0.05），側頸部淋巴結轉移率分彆為4.9％和13.7％（χ2＝5.035，P＜0.05）；男性與女性中央區淋巴結轉移率分彆為42.1％、26.1％（χ2＝5.224，P＜0.05），側頸部淋巴結轉移率分彆為21.1％、6.3％（χ2＝10.604，P＜0.01）。年齡≤45歲和＞45歲者的中央區淋巴結轉移率分彆為37.9％、21.1％（χ2＝7.792，P＜0.01）。中央區淋巴結轉移時側頸部淋巴結轉移率為17.1％，中央區淋巴結未轉移而髮生側頸淋巴結轉移率為6.7％（χ2＝5.947，P＜0.05）。結論 cN0期PTMC患者均應規範性清掃中央區淋巴組織，對于腫瘤直徑＞5 mm的男性PTMC患者應積極探查側頸部淋巴組織，以髮現亞臨床轉移癌竈，指導進一步手術方案。
목적：탐색cN0기갑상선유두상미소암（ papillary thyroid microcarcinoma ，PTMC）림파결전이규률，병평개기경부림파결청소범위。방법대233례cN0기PTMC적림상자료행회고성분석，용χ2검험대성별、년령、종류직경여림파결전이지간적관계작단인소분석。결과233례cN0기PTMC환자경부림파결전이솔34.8％（중앙구30.0％，측경부9.9％）。종류직경≤5 mm자여＞5 mm자중앙구림파결전이솔분별위21.6％화36.6％（χ2＝6.199，P＜0.05），측경부림파결전이솔분별위4.9％화13.7％（χ2＝5.035，P＜0.05）；남성여녀성중앙구림파결전이솔분별위42.1％、26.1％（χ2＝5.224，P＜0.05），측경부림파결전이솔분별위21.1％、6.3％（χ2＝10.604，P＜0.01）。년령≤45세화＞45세자적중앙구림파결전이솔분별위37.9％、21.1％（χ2＝7.792，P＜0.01）。중앙구림파결전이시측경부림파결전이솔위17.1％，중앙구림파결미전이이발생측경림파결전이솔위6.7％（χ2＝5.947，P＜0.05）。결론 cN0기PTMC환자균응규범성청소중앙구림파조직，대우종류직경＞5 mm적남성PTMC환자응적겁탐사측경부림파조직，이발현아림상전이암조，지도진일보수술방안。
Objective To study the rule of lymph node metastasis rate in cN 0 papillary thyroid microcar-cinoma( cN0-PTMC) and to evaluate an appropriate region of neck dissection .Methods Data of 233 cases of cN0-PTMC were retrospectively analyzed .Univariate analysis with chi-square test was used to analyze the statisti-cal correlation between gender , age, tumor diameter and lymph node metastasis respectively .Results 81 out of 233 patients(34.8%)had cervical lymph node metastasis (30.0%in central region and 9.9%in lateral region). For patients with tumor diameter ( D)≤5 mm and D>5 mm, lymph node metastasis rate in central region was 21.6%and 36.6%(χ2 =6.199,P<0.05) and it was 4.9% and 13.7% respectively in lateral region (χ2 =5.035,P<0.05).For male and female patients, lymph node metastasis rate in central region was 42.1% and 26.1%respectively(χ2 =5.224,P<0.05), and it was 21.1% and 6.3% respectively in lateral region (χ2 =10.604,P<0.01).Lymph node metastasis rate in patients≤45 years old and >45 years old was 37.9% and 21.1% respectively (χ2 =7.792, P <0.01 ) .The lateral region lymph node metastasis rate was 17.1% and 6.7%when the central region lymph node was infringed or not (χ2 =5.947, P<0.05).Conclusions All cN0-PTMC patients should have a normative central neck dissection .Male patients with PTMC and tumor diameter >5 mm should receive the lateral neck lymphoid tissue exploration during surgery in order to find subclinical metas -tasis.
