Department of Otorhinolaryngology, School of Medicine, Mersin University, Mersin, Turkey.
Eur Arch Otorhinolaryngol. 2010 Jul;267(7):1117-21. doi: 10.1007/s00405-009-1185-3. Epub 2010 Jan 7.
The objective of the study was to evaluate the incidence of level IIb lymph node metastases in neck dissections for thyroid papillary carcinoma (TPC) patients. 47 neck dissections of 33 patients with TPC were prospectively evaluated. Selective neck dissections (levels II, III, IV, and V) were performed in all cases. If level I lymph node metastasis was suspected during the procedure, level I dissection was also performed. All level IIb specimens were sent separately from the remainder of the neck dissection for the pathological examination. The number of dissected and metastatic lymph nodes in each specimen was recorded. Twenty-two of 47 neck dissections (46.8%) were positive for the lymph node metastasis. Among 47 neck dissection specimens, the incidence of lymph node metastasis at level II was 12.7% (6 of 47) and level IIb was 2.1% (1 of 47). The rate of level IIb lymph node involvement among patients with metastatic cervical lymph nodes was 4.5% (1 of 22). The specimen with metastatic lymph node at level IIb had also metastasis at levels IIa, III, IV, and V. The results of the present study suggested that lymph node metastases in level IIb are rare in patients with TPC undergoing neck dissection.
本研究旨在评估甲状腺乳头状癌（TPC）患者颈部清扫术 IIb 级淋巴结转移的发生率。前瞻性评估了 33 例 TPC 患者的 47 例颈部清扫术。所有病例均行选择性颈部清扫术（II、III、IV 和 V 区）。如果术中怀疑存在 I 区淋巴结转移，则行 I 区清扫术。所有 IIb 区标本均与颈部清扫术的其余部分分开送检行病理检查。记录每个标本中清扫和转移的淋巴结数量。47 例颈部清扫术中有 22 例（46.8%）为淋巴结转移阳性。47 例颈部清扫术标本中，II 区淋巴结转移发生率为 12.7%（47 例中有 6 例），IIb 区为 2.1%（47 例中有 1 例）。颈淋巴结转移患者中 IIb 区淋巴结受累的比例为 4.5%（22 例中有 1 例）。IIb 区有转移淋巴结的标本也有 IIa、III、IV 和 V 区的转移。本研究结果提示，TPC 患者行颈部清扫术时 IIb 区淋巴结转移较为罕见。
