甲状腺乳头状癌同侧和对侧中央区淋巴结转移：淋巴结转移的模式和预测因素。
Ipsilateral and contralateral central lymph node metastasis in papillary thyroid cancer: patterns and predictive factors of nodal metastasis.
机构信息
Department of Surgery, Seoul National University, College of Medicine, Seoul, Republic of Korea.
出版信息
Head Neck. 2013 May;35(5):672-6. doi: 10.1002/hed.23016. Epub 2012 Jun 19.
BACKGROUND
The aims of this study were to evaluate the rate and risk factors of ipsilateral and contralateral central lymph node (CLN) metastases in patients with papillary thyroid cancer (PTC).
METHODS
A total of 161 patients who underwent total thyroidectomy with prophylactic CLN dissection (CLND) to treat PTC were enrolled.
RESULTS
Of 134 total cases excluding tumors located in the isthmus and bilateral lobes, 72 cases (53.7%) involved CLN metastases. Tumor size, age, and sex were found to be predictive of ipsilateral CLN metastasis and the rate of ipsilateral CLN metastasis in tumors > 1 cm was 59.6%. Contralateral CLN metastases were more prevalent only in tumors that already had ipsilateral CLN metastases (27.3%, p = .002).
CONCLUSIONS
It is suggested that risk factors of ipsilateral and contralateral CLN metastases should be considered while planning the extent of CLND in patients with clinically node-negative and unilateral PTC upon preoperative ultrasonography.
背景
本研究旨在评估甲状腺乳头状癌（PTC）患者同侧和对侧中央淋巴结（CLN）转移的发生率和相关危险因素。
方法
共纳入 161 例因 PTC 行甲状腺全切除术加预防性中央区淋巴结清扫术（CLND）的患者。
结果
在排除位于峡部和双侧叶的肿瘤的 134 例患者中，72 例（53.7%）存在 CLN 转移。肿瘤大小、年龄和性别是同侧 CLN 转移的预测因素，且肿瘤＞1cm 者同侧 CLN 转移率为 59.6%。仅在同侧 CLN 已有转移的肿瘤中才更常见对侧 CLN 转移（27.3%，p=.002）。
结论
建议在术前超声检查提示临床淋巴结阴性和单侧 PTC 的患者中，规划 CLND 范围时，应考虑同侧和对侧 CLN 转移的危险因素。
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