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目的:探讨Ⅵ区各组淋巴结清扫在cN0期甲状腺乳头状癌手术中的意义。方法:收集确诊为cN0甲状腺乳头状癌并行Ⅵ区各组淋巴结清扫的患者150例,行患侧甲状腺腺叶+峡部切除,同期行患侧Ⅵ区淋巴结清扫。对甲状腺和清扫的Ⅵ区各组淋巴结进行病理检查并测定甲状腺乳头状癌的大小、部位、是否有膜侵犯、淋巴结数目、淋巴结是否转移等。结果:150例患者均行Ⅵ区各组淋巴结清扫,93例发现Ⅵ区淋巴结转移,转移率为62.0%。Ⅵ区中各组淋巴结转移率:气管旁淋巴结组62.0%(93/150),喉前淋巴结组4.67%(7/150),气管前淋巴结组3.33%(5/150),其中气管旁喉返神经腹侧淋巴结组52.0%(78/150),气管旁喉返神经背侧淋巴结组21.33%(32/150)。结论:cN0甲状腺乳头状癌Ⅵ区淋巴结转移率高,转移率由高到低依次为:气管旁淋巴结组、喉前淋巴结组、气管前淋巴结组,其中气管旁喉返神经腹侧淋巴结组在中央区各组淋巴结中转移率最高。
Objective: To investigate the significance of lymph node dissection in group Ⅵ in cN0 thyroid papillary carcinoma. Methods: A total of 150 patients with lymph node dissection in group VI were selected for cN0 thyroid papillary carcinoma. The thyroid gland and isthmus were resected in the affected area. The thyroid gland and the Ⅵ area of the Ⅵ group were examined by pathological examination and the size, location, membrane invasion, lymph node number and lymph node metastasis of thyroid papillary carcinoma were determined. Results: All the 150 patients underwent lymph node dissection in Ⅵ region, 93 of them had Ⅵ lymph node metastasis. The metastasis rate was 62.0%. The rate of lymph node metastasis in each group Ⅵ: 62.0% (93/150) in the group of para-trachea, 4.67% (7/150) in the group of pre-laryngeal lymph nodes, and 3.33% (5/150) in the group of anterior tracheal lymph nodes 52.0% (78/150) in the ventral lymph node group and 21.33% (32/150) in the dorsal paravertebral laryngeal nerve group. Conclusion: The metastasis rate of lymph node in cN0 thyroid papillary carcinoma in Ⅵ region is high, the metastasis rate is descending order of trachea lymph node group, pre-laryngeal lymph node group and anterior bronchial lymph node group, in which the tracheal paralytic recurrent nerve ventral lymph node group is in the center District lymph node metastasis in the highest rate.