中央淋巴结转移：它是甲状腺乳头状癌侧方淋巴结受累的可靠指标吗？
Central lymph node metastasis: is it a reliable indicator of lateral node involvement in papillary thyroid carcinoma?
机构信息
Department of Head and Neck Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University, Hangzhou, Zhejiang, 310016, China.
出版信息
World J Surg. 2010 Feb;34(2):237-41. doi: 10.1007/s00268-009-0347-1.
BACKGROUND
The purpose of the present study was to evaluate the reliability of central lymph node metastases in predicting lateral node involvement in papillary thyroid carcinoma (PTC).
METHODS
This retrospective study consists of 121 patients with PTC who underwent ipsilateral selective neck dissection. The quantitative relationship between central and lateral lymph node metastases (LNM) was analyzed.
RESULTS
A total of 86 patients (71.1%) had pathologically proven LNM; 55 patients had LNM in both the central and lateral compartments, 22 patients had only central LNM, and 9 patients had skip metastasis to lateral nodes. The sensitivity of central node involvement to predict lateral LNM was 85.9%, the specificity was 61.4%. The presence of two or more positive central nodes was associated with a high incidence of lateral LNM (70-93.3%), when compared with none (20.5%) or one (47.4%) positive central node.
CONCLUSIONS
The node status of the central compartment is moderately predictive of that of lateral compartment. The presence of two or more positive central nodes may be of value in predicting lateral node involvement.
背景
本研究旨在评估中央淋巴结转移对预测甲状腺乳头状癌（PTC）侧方淋巴结受累的可靠性。
方法
本回顾性研究纳入了 121 例接受同侧选择性颈淋巴结清扫术的 PTC 患者。分析了中央淋巴结和侧方淋巴结转移（LNM）之间的定量关系。
结果
共有 86 例（71.1%）患者的 LNM 经病理证实；55 例患者中央和侧方淋巴结均有转移，22 例患者仅有中央淋巴结转移，9 例患者发生侧方跳跃性转移。中央淋巴结受累预测侧方 LNM 的敏感性为 85.9%，特异性为 61.4%。与无阳性中央淋巴结（20.5%）或仅一个阳性中央淋巴结（47.4%）相比，两个或更多阳性中央淋巴结与侧方 LNM 的高发生率（70-93.3%）相关。
结论
中央区淋巴结状态对侧方区淋巴结状态具有中等程度的预测价值。两个或更多阳性中央淋巴结的存在可能有助于预测侧方淋巴结受累。
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